Provider Demographics
NPI:1619910932
Name:KHALAF RABADI, M.D., P.C.
Entity Type:Organization
Organization Name:KHALAF RABADI, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHALAF
Authorized Official - Middle Name:E
Authorized Official - Last Name:RABADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-586-6500
Mailing Address - Street 1:2119 KLOCKNER RD
Mailing Address - Street 2:BUILDING 8, SUITE 34
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3417
Mailing Address - Country:US
Mailing Address - Phone:609-586-6500
Mailing Address - Fax:609-586-8694
Practice Address - Street 1:2119 KLOCKNER RD
Practice Address - Street 2:BUILDING 8, SUITE 34
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3417
Practice Address - Country:US
Practice Address - Phone:609-586-6500
Practice Address - Fax:609-586-8694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0716741001OtherAMERIHEALTH
NJPSF0604Other1ST OPTION
NJMEP106OtherOXFORD
NJ146654OtherPA BLUE SHIELD
NJ554529OtherAETNA
NJ0768201Medicaid
NJPSF0604Other1ST OPTION