Organization
RONI RAFAILOV NP FAMILY HEALTH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONI RAFAILOV (OWNER)
(718) 864-5734
Entity
Organization
Contact information
Practice address
21805 GRAND CENTRAL PKWY, QUEENS VILLAGE, NY 11427-1435
(718) 864-5734
Mailing address
21805 GRAND CENTRAL PKWY, QUEENS VILLAGE, NY 11427-1435
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
364SF0001X
Family Health Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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