Organization
CORONA MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AFSHIN TAVAKOLY M.D. (OFFICER/PHYSICIAN)
(917) 605-7233
Entity
Organization
Contact information
Practice address
40-11 WARREN ST, 2ND FLOOR, ELMHURST, NY 11373-1700
(718) 426-8100
(718) 396-0407
Mailing address
PO BOX 650067, FRESH MEADOWS, NY 11365-0067
(917) 605-7233
(718) 998-4252
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
Other
Enumeration date
09/21/2012
Last updated
10/30/2024
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