| Igal Khorshidi, M.d., P.c. | |
|
7911 41st Ave A108 Elmhurst NY 11373-1258 | |
| (212) 734-0000 | |
| (646) 661-2795 |
| Full Name | Igal Khorshidi, M.d., P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 7911 41st Ave, Elmhurst, New York |
| Authorized Official Name and Position | Igal Khorshidi (PRESIDENT) |
| Authorized Official Contact | 5164560304 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Igal Khorshidi, M.d., P.c. 7911 41st Ave A108 Elmhurst NY 11373-1258 Ph: (212) 734-0000 | Igal Khorshidi, M.d., P.c. 7911 41st Ave A108 Elmhurst NY 11373-1258 Ph: (212) 734-0000 |
| NPI Number | 1871930073 |
|---|---|
| Provider Enumeration Date | 05/29/2013 |
| Last Update Date | 01/06/2015 |
| Medicare PECOS PAC ID | 2163646688 |
|---|---|
| Medicare Enrollment ID | O20140624000091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871930073 | NPI | - | NPPES |
| 03540943 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 256986 (New York) | Primary |
| Provider Name | Igal Khorshidi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1659500668 PECOS PAC ID: 4587828322 Enrollment ID: I20120607000383 |
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