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Individual

DR. OMAR S KHOKHAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3325 E MAIN STREET RD, ATTICA, NY 14011-9506
(585) 591-0800
(585) 591-4204
Mailing address
PO BOX 265, 3325 E MAIN ST, ATTICA, NY 14011-0265
(585) 591-0800
(585) 591-4204

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
140294
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00010090701
UNIVERA
NY
01
000607913003
BLUE CROSS
NY
01
0047126
GHI
NY
05
00633078
NY
01
010065467
RAILROAD MEDICARE
NY
01
0101478
INDH
NY
01
1402940
WORKERS COMPENSATION
NY
01
1402941
SATE INS FUND
NY
01
161166300
EMPIRE
NY
01
4301608
AETNA
NY
01
P010140294
PREMIER HELATH PLAN
NY
Enumeration date
08/10/2005
Last updated
01/28/2011
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