Provider Demographics
NPI:1225152564
Name:KHOURY, JOSEPH C (LAC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:C
Last Name:KHOURY
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 WESTCHESTER AVE
Mailing Address - Street 2:STE# 316
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2907
Mailing Address - Country:US
Mailing Address - Phone:914-949-8501
Mailing Address - Fax:914-949-8502
Practice Address - Street 1:244 WESTCHESTER AVE
Practice Address - Street 2:STE# 316
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2907
Practice Address - Country:US
Practice Address - Phone:914-949-8501
Practice Address - Fax:914-949-8502
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001437-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP2083468OtherOXFORD INS.
NY82Z493OtherBC-BS INS.