Individual
DR. AHMED S KHALIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, RPVI
Contact information
Practice address
8906 135TH ST, 2T, JAMAICA, NY 11418-2821
(718) 206-7110
(718) 206-7111
Mailing address
80 MARCUS DR, PROVIDER ENROLLMENT, MELVILLE, NY 11747-4230
(631) 391-8366
(631) 454-4161
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
036-115750
IL
2086S0129X
Vascular Surgery Physician
Primary
249302
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03022373
—
NY
Enumeration date
05/22/2008
Last updated
01/17/2013
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