Khaled Mohamed, MD LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

47217 Issued in CT

Legal business name

KHALED MOHAMED, MD LLC

Practice address

35 Old Tavern Rd
Suite 101
Orange, CT 06477-3450

Phone

(914) 830-0813

Fax

(203) 717-0138

NPI assigned

Aug 8, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Khaled Mohamed, MD

Title

Owner

Phone

(914) 682-0965

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470614400000",
    "number": "1922552967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 OLD TAVERN RD",
            "address_2": "SUITE 101",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773450",
            "telephone_number": "914-830-0813",
            "fax_number": "203-717-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 OLD TAVERN RD",
            "address_2": "SUITE 101",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773450",
            "telephone_number": "914-830-0813",
            "fax_number": "203-717-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHALED MOHAMED, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-08",
        "last_updated": "2016-08-08",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "KHALED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-682-0965",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "47217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1124049861",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Kearney
• William Keefe
• Kathryn Kelly, LPC, CLAT
• Kourtney Marie Kelly, RN
• Kennedy & Perkins, Inc.
• Ali Khan
• Anum Khan
• Jee Yoon Kim, ANP
• Kristina May Kim
• Rosalyn F Klein, LCSW

• Psychiatry Physician in Orange, CT
• Providers in Orange, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.