Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 037788 | CT |
NPI | 1053362467 |
---|---|
Provider Name | Magdi Khalil |
First Address | New Milford, CT 06776-3626 |
Second Address | New Milford, CT 06776-3626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 26/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001377888 | (05) | CT |
100000296 | RAILROAD MEDICARE (01) | |
1255513941 | GROUP NPI (01) | |
G98442 | (02) |