MEDICARE: DR. ROOSEY KHAWLY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	109301	NY

General Provider Information

NPI Number	:	1336588581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROOSEY KHAWLY MD

Provider Business Mailing Address
First Line	:	PO BOX 3387
Second Line	:
City	:	PALM BEACH
State	:	FL
Zip	:	33480-1587
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1322 OCEAN AVE
Second Line	:
City	:	POINT PLEASANT BEACH
State	:	NJ
Zip	:	08742-4191
Country	:	US
Telephone Number	:	561-306-0390
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2013
Last Update Date	:	01/22/2024

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