Provider Demographics
NPI:1871706572
Name:KHALIFE, SAMI (MD)
Entity type:Individual
Prefix:
First Name:SAMI
Middle Name:
Last Name:KHALIFE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 PARK AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4329
Mailing Address - Country:US
Mailing Address - Phone:212-203-6384
Mailing Address - Fax:
Practice Address - Street 1:16 PARK AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4329
Practice Address - Country:US
Practice Address - Phone:212-203-6384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2015-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2603692084P0800X, 2084P0800X
DCMD0367582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7382081Medicare PIN
NY00476875Medicaid
OH2743713Medicaid
NY334054Medicare PIN