Provider Demographics
NPI:1578831491
Name:ALZOMAN, KHALID ABDULLAH (MD)
Entity Type:Individual
Prefix:
First Name:KHALID
Middle Name:ABDULLAH
Last Name:ALZOMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 E 70TH ST
Mailing Address - Street 2:APT 10K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5342
Mailing Address - Country:US
Mailing Address - Phone:201-873-5617
Mailing Address - Fax:
Practice Address - Street 1:435 E 70TH ST
Practice Address - Street 2:APT 10K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5342
Practice Address - Country:US
Practice Address - Phone:201-873-5617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP82649208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery