Provider Demographics
NPI:1255549713
Name:KHOURY, JOHN SAFA (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:SAFA
Last Name:KHOURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 OLD YORK RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3816
Mailing Address - Country:US
Mailing Address - Phone:215-957-9250
Mailing Address - Fax:215-957-9254
Practice Address - Street 1:1151 OLD YORK RD STE 200
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3816
Practice Address - Country:US
Practice Address - Phone:215-957-9250
Practice Address - Fax:215-957-9254
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4373992084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD437399OtherSTATE LICENSE