Provider Demographics
NPI:1285805937
Name:RABADI, KHALAF E (MD)
Entity type:Individual
Prefix:
First Name:KHALAF
Middle Name:E
Last Name:RABADI
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 1:2119 KLOCKNER RD
Mailing Address - Street 2:BUILDING 8, SUITE 34
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3417
Mailing Address - Country:US
Mailing Address - Phone:609-586-6500
Mailing Address - Fax:609-586-8694
Practice Address - Street 1:2119 KLOCKNER RD
Practice Address - Street 2:BUILDING 8, SUITE 34
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3417
Practice Address - Country:US
Practice Address - Phone:609-586-6500
Practice Address - Fax:609-586-8694
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA45032207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0768201Medicaid
NJ110018746OtherRAIL ROAD MEDICARE
NJ223709556OtherBLUE SHEILD
NJPSF0604OtherFIRST OPTION
NJ0716741001OtherAMERIHEALTH HMO
NJMEP106OtherOXFORD
NJ2769103000OtherAMERIHEALTH
NJ554529OtherAETNA
NJ2769103000OtherAMERIHEALTH