Provider Demographics
NPI:1447318993
Name:KHOURY MEDICAL CARE PC
Entity type:Organization
Organization Name:KHOURY MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EYAD
Authorized Official - Middle Name:M
Authorized Official - Last Name:KHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-921-5242
Mailing Address - Street 1:8008 NARROWS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-2831
Mailing Address - Country:US
Mailing Address - Phone:718-921-5242
Mailing Address - Fax:718-921-5242
Practice Address - Street 1:670 92ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3632
Practice Address - Country:US
Practice Address - Phone:718-833-8777
Practice Address - Fax:718-833-7177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240972207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWWT371Medicare PIN