Provider Demographics
NPI:1942269048
Name:KHOURY, DENNIS J (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:J
Last Name:KHOURY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8118 BUSTLETON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-2803
Mailing Address - Country:US
Mailing Address - Phone:215-342-8118
Mailing Address - Fax:215-725-4999
Practice Address - Street 1:8118 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19152-2803
Practice Address - Country:US
Practice Address - Phone:215-342-8118
Practice Address - Fax:215-725-4999
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD019923E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB34689Medicare UPIN