Provider Demographics
NPI:1699814780
Name:KHUSID, MARIA (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:KHUSID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 19TH AVE #3F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-1719
Mailing Address - Country:US
Mailing Address - Phone:718-621-3413
Mailing Address - Fax:
Practice Address - Street 1:585 SCHENECTEDY AVE KINGSBROOK JEWISH MEDICAL CENTER
Practice Address - Street 2:MINKIN 3 PSYCHIATRIC UNIT
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1891
Practice Address - Country:US
Practice Address - Phone:718-604-5070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1940622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01841318Medicaid
NY01841318Medicaid
07J551Medicare ID - Type Unspecified