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Organization

ROCKAWAY PHYSICIAN PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ABIOLA FAMILUSI MD (CHAIRMAN)
(718) 327-3722
Entity
Organization

Contact information

Practice address
327 BEACH 19TH ST, FAR ROCKAWAY, NY 11691-4423
(718) 869-7223
(718) 869-7176
Mailing address
529 BEACH 20TH ST, FAR ROCKAWAY, NY 11691-3645
(718) 327-3722
(718) 327-3294

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02593557
NY
Enumeration date
04/04/2007
Last updated
08/22/2020
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