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General NPI Number Information
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NPI Number | 1336588581
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Entity Type | Individual
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Provider Name | ROOSEY KHAWLY MD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 1322 OCEAN AVE
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City | POINT PLEASANT BEACH
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State | NJ
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Zip | 08742-4191
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Country | US
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Telephone | 561-306-0390
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3387
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City | PALM BEACH
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State | FL
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Zip | 33480-1587
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Country | US
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Telephone |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 109301
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License Number State | NY
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