Provider Demographics
NPI:1619101581
Name:ADVANCED MEDICAL ASSOCIATES OF WESTCHESTER, PC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL ASSOCIATES OF WESTCHESTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAROUBA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-207-7600
Mailing Address - Street 1:880 MILE SQUARE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-2141
Mailing Address - Country:US
Mailing Address - Phone:914-207-7600
Mailing Address - Fax:914-207-7601
Practice Address - Street 1:880 MILE SQUARE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-2141
Practice Address - Country:US
Practice Address - Phone:914-207-7600
Practice Address - Fax:914-207-7601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2012-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247049173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty