MEDICARE: GAMAL GARHY KHALIFA 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	208M00000X	Hospitalist Physician	226153	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00092394	OTHER	NY	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922096023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAMAL GARHY KHALIFA MD

Provider Business Mailing Address
First Line	:	100 PARK STREET
Second Line	:	GLENS FALLS HOSPITAL - CREDENTIALING
City	:	GLENS FALLS
State	:	NY
Zip	:	12801-4413
Country	:	US
Telephone Number	:	518-926-5924
Fax Number	:	518-926-6983

Provider Business Practice Location Address
First Line	:	100 PARK ST
Second Line	:	GLENS FALLS HOSPITAL
City	:	GLENS FALLS
State	:	NY
Zip	:	12801-4413
Country	:	US
Telephone Number	:	518-926-5925
Fax Number	:	518-926-5917

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	04/14/2022

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