Organization
BOULEVARD SURGICAL CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DROR ROSENFELD MD (ADMINISTRATOR)
(718) 545-5050
Entity
Organization
Contact information
Practice address
46-04 31ST AVENUE, LONG ISLAND CITY, NY 11103-1842
(718) 545-5050
(718) 545-5052
Mailing address
46-04 31ST AVENUE, LONG ISLAND CITY, NY 11103-1842
(718) 545-5050
(718) 545-5052
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
700326OR
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01178174
—
NY
Enumeration date
07/11/2006
Last updated
08/16/2011
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