Provider Demographics
NPI:1518165455
Name:M K ALCHOKHACHY INC
Entity Type:Organization
Organization Name:M K ALCHOKHACHY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:MODHAFFER
Authorized Official - Middle Name:K
Authorized Official - Last Name:AL-CHOKHACHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-746-6300
Mailing Address - Street 1:PO BOX 900
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02362-0900
Mailing Address - Country:US
Mailing Address - Phone:508-746-6300
Mailing Address - Fax:508-747-6602
Practice Address - Street 1:143 COURT ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-3807
Practice Address - Country:US
Practice Address - Phone:508-746-6300
Practice Address - Fax:508-747-6602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA28348208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
452855OtherAETNA
MA8023OtherHARVARD PILGRIM
MA9710914Medicaid
MA705633OtherTUFTS
1701051OtherUNITED HEALTH CARE
452855OtherAETNA
=========002OtherTRICARE