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General NPI Number Information
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NPI Number | 1144221367
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Entity Type | Individual
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Provider Name | TAMIM J KHALIQI MD
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Gender | Male
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 04/09/2021
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Provider Practice Location Address
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Address Line | GUTHRIE CORTLAND MEDICAL CENTER 134 HOMER AVE
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City | CORTLAND
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State | NY
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Zip | 13045-1206
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Country | US
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Telephone | 315-939-0409
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Fax |
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Provider Business Mailing Address
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Address Line | 10 SLEEPY HOLLOW LN
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City | NEW HARTFORD
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State | NY
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Zip | 13413-9503
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Country | US
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Telephone | 315-724-3456
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 10006
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 257121
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License Number State | NY
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