Basic Information
| Provider Information | |||||||||
| NPI: | 1710640495 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | K&H MEDICAL -PHIL, PLLC | ||||||||
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| OtherOrganizationName: | MOBILE VASCULAR PHYSICIANS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 HICKSVILLE RD | ||||||||
| Address2: | |||||||||
| City: | BETHPAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117143443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167171839 | ||||||||
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| Practice Location | |||||||||
| Address1: | 235 N BROAD ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191071531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167171839 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2021 | ||||||||
| LastUpdateDate: | 03/18/2022 | ||||||||
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| AuthorizedOfficialLastName: | HALPERT | ||||||||
| AuthorizedOfficialFirstName: | ELIEZER | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5167171839 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 03/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 2085R0204X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology |
No ID Information.