Provider Demographics
NPI:1841361771
Name:KHULUSI, NAMI (MD)
Entity type:Individual
Prefix:DR
First Name:NAMI
Middle Name:
Last Name:KHULUSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:615 HOPE RD
Mailing Address - Street 2:BLDG 2A
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724
Mailing Address - Country:US
Mailing Address - Phone:848-456-4485
Mailing Address - Fax:848-456-4492
Practice Address - Street 1:615 HOPE RD
Practice Address - Street 2:BLDG 2A
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-1277
Practice Address - Country:US
Practice Address - Phone:848-456-4485
Practice Address - Fax:848-456-4492
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06313900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine