Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Roni Rafailov NP Family Health PC

Organization Family Medicine Physician · NPI 1528894268

Roni Rafailov NP Family Health PC provides Family Medicine Physician services in Queens Village, New York. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

21805 Grand Central Pkwy
Queens Village, NY 11427-1435
Phone: (718) 864-5734
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Health Clinical Nurse Specialist (primary) Taxonomy 364SF0001X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1528894268
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roni Rafailov — Owner · (718) 864-5734
NPI enumeratedSeptember 10, 2024
Last updated in NPPESSeptember 10, 2024
Certification dateSeptember 10, 2024
Mailing address21805 Grand Central Pkwy, Queens Village, NY 11427-1435

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