Provider Demographics
NPI:1710204383
Name:MASOOD KHATAMEE, M.D., P.C.
Entity Type:Organization
Organization Name:MASOOD KHATAMEE, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MASOOD
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:KHATAMEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-288-3737
Mailing Address - Street 1:875 PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0341
Mailing Address - Country:US
Mailing Address - Phone:212-288-3737
Mailing Address - Fax:212-744-6536
Practice Address - Street 1:875 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0341
Practice Address - Country:US
Practice Address - Phone:212-288-3737
Practice Address - Fax:212-744-6536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-22
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY109930207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B78868Medicare UPIN
660711Medicare PIN