Provider Demographics
NPI:1689362501
Name:KHALIFA, OSAMA K ABDELHAMID (BDS, MS, FFDRCSI)
Entity Type:Individual
Prefix:DR
First Name:OSAMA
Middle Name:K ABDELHAMID
Last Name:KHALIFA
Suffix:
Gender:M
Credentials:BDS, MS, FFDRCSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3151 41ST ST APT 3
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-4782
Mailing Address - Country:US
Mailing Address - Phone:929-257-9160
Mailing Address - Fax:
Practice Address - Street 1:345 E 24TH ST # 3W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4020
Practice Address - Country:US
Practice Address - Phone:212-998-4086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0001381223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery