Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 060118 | NY |
Y | 213EG0000X | General Practice | 060118 | NY |
NPI | 1003349770 |
---|---|
Provider Name | Joseph Khaloo |
First Address | Richmond Hill, NY 11418-1321 |
Second Address | Richmond Hill, NY 11418-1321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2017 |
Last Update Date | 07/02/2019 |