Provider Demographics
NPI:1396792313
Name:KHUSID, RUDOLF (MD)
Entity type:Individual
Prefix:DR
First Name:RUDOLF
Middle Name:
Last Name:KHUSID
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 1:1000 FLORAL VALE BLVD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5569
Mailing Address - Country:US
Mailing Address - Phone:215-785-9500
Mailing Address - Fax:
Practice Address - Street 1:1000 FLORAL VALE BLVD
Practice Address - Street 2:SUITE 125
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5569
Practice Address - Country:US
Practice Address - Phone:215-785-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066101L207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017989940001Medicaid
110196107OtherRAILROAD MEDICARE
004380Medicare PIN
H06893Medicare UPIN
033168LIHMedicare ID - Type Unspecified