| Yonkers Family Practice, Pc | |
|
45 Ludlow St Suite 700 Yonkers NY 10705-1947 | |
| (914) 375-2700 | |
| (914) 375-0404 |
| Full Name | Yonkers Family Practice, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 45 Ludlow St, Yonkers, New York |
| Authorized Official Name and Position | Khalil Ibrahim Innabi (M.D.) |
| Authorized Official Contact | 9143752700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yonkers Family Practice, Pc 45 Ludlow St Suite 700 Yonkers NY 10705-1947 Ph: (914) 375-2700 | Yonkers Family Practice, Pc 45 Ludlow St Suite 700 Yonkers NY 10705-1947 Ph: (914) 375-2700 |
| NPI Number | 1497944284 |
|---|---|
| Provider Enumeration Date | 10/17/2007 |
| Last Update Date | 03/05/2008 |
| Medicare PECOS PAC ID | 5092899666 |
|---|---|
| Medicare Enrollment ID | O20080221000364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497944284 | NPI | - | NPPES |
| 02041087 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 204019 (New York) | Primary |
| Provider Name | Khalil I Innabi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336184290 PECOS PAC ID: 8527048636 Enrollment ID: I20040721000139 |
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