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NPI Code Detail

MEDICARE: SAMIR AHMED KHIRIE MD

MEDICARE: SAMIR AHMED KHIRIE 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
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine Physician25MA13010200NJ

General Provider Information

NPI Number : 1487342978
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMIR AHMED KHIRIE MD
Provider Business Mailing Address
First Line : 201 LYONS AVE
Second Line :
City : NEWARK
State : NJ
Zip : 07112-2027
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 201 LYONS AVE
Second Line :
City : NEWARK
State : NJ
Zip : 07112-2027
Country : US
Telephone Number : 973-926-6671
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2023
Last Update Date : 05/15/2026

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