| Khader Medical Pc | |
|
1072 Grand Concourse Bronx NY 10456-3901 | |
| (718) 681-4000 | |
| Not Available |
| Full Name | Khader Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1072 Grand Concourse, Bronx, New York |
| Authorized Official Name and Position | Rawand Khader (OWNER) |
| Authorized Official Contact | 2122552333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Khader Medical Pc 25 Bank St Apt 214 H White Plains NY 10606-7000 Ph: () - | Khader Medical Pc 1072 Grand Concourse Bronx NY 10456-3901 Ph: (718) 681-4000 |
| NPI Number | 1821304916 |
|---|---|
| Provider Enumeration Date | 08/26/2010 |
| Last Update Date | 08/26/2010 |
| Medicare PECOS PAC ID | 7517192859 |
|---|---|
| Medicare Enrollment ID | O20131023000343 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821304916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 002706 (New York) | Primary |
| Provider Name | Rawand Khader |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659452241 PECOS PAC ID: 6103920095 Enrollment ID: I20070403000073 |
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