Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 303794 | NY |
NPI | 1003105792 |
---|---|
Provider Name | Dr. Usama Khayyal |
First Address | Astoria, NY 11102-2251 |
Second Address | Astoria, NY 11102-2251 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2011 |
Last Update Date | 28/06/2020 |