Provider Demographics
NPI:1588089692
Name:MAURICE M KHOSH MD PC
Entity type:Organization
Organization Name:MAURICE M KHOSH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KHOSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-339-9988
Mailing Address - Street 1:580 PARK AVE
Mailing Address - Street 2:SUITE 1BE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7313
Mailing Address - Country:US
Mailing Address - Phone:212-339-9988
Mailing Address - Fax:
Practice Address - Street 1:580 PARK AVE
Practice Address - Street 2:SUITE 1BE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7313
Practice Address - Country:US
Practice Address - Phone:212-339-9988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY188633207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty