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NPI Code Detail

MEDICARE: MICHAEL KHOURY

MEDICARE: MICHAEL KHOURY
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
11223G0001XGeneral Practice Dentistry061852NY

General Provider Information

NPI Number : 1104453422
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL KHOURY
Provider Business Mailing Address
First Line : 111 E 210TH ST
Second Line :
City : BRONX
State : NY
Zip : 10467-2401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1537 WESTCHESTER AVE
Second Line :
City : BRONX
State : NY
Zip : 10472-2908
Country : US
Telephone Number : 718-617-0624
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2020
Last Update Date : 02/26/2026

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