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Organization

RAYMOND KHOUDARY MDPC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DEBBIE BROWN (BILLING OFFICE)
(570) 970-1400
Entity
Organization

Contact information

Practice address
190 S RIVER ST, PLAINS, PA 18705-1149
(570) 970-1400
(570) 970-1403
Mailing address
190 S RIVER ST, PLAINS, PA 18705-1149
(570) 970-1400
(570) 970-1403

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
MD048279L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0031149000
IBC
PA
01
020260900
FEDERAL BLACK LUNG
PA
01
079698
FPH
PA
01
23578
GHP
PA
01
333056
HBS
PA
01
4557012
AETNA
PA
01
50044349
CBC
PA
01
8954255
CIGNA
PA
Enumeration date
05/04/2007
Last updated
07/06/2010
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