Provider Demographics
NPI:1982827283
Name:KHOWONG, KHAMSY KEVIN (RPH)
Entity Type:Individual
Prefix:MR
First Name:KHAMSY
Middle Name:KEVIN
Last Name:KHOWONG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10216 63RD AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1046
Mailing Address - Country:US
Mailing Address - Phone:212-923-2525
Mailing Address - Fax:212-222-4893
Practice Address - Street 1:133 MORNINGSIDE AVE.
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4342
Practice Address - Country:US
Practice Address - Phone:212-923-2525
Practice Address - Fax:212-222-4893
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040208183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist