| Doctor Name: | DR. OMAR S KHOKHAR |
| NPI Number: | 1750382834 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 140294 |
| Business Practice Address: | 3325 E Main Street Rd Attica, NY - 140119506 |
| Business Phone Number: | 5855910800 |
| Business Fax Number: | 5855914204 |
| Mailing Address: | Po Box 265, 3325 E Main St ATTICA |
| State: | NY |
| Postal Code: | 140110265 |
| Phone Number: | 5855910800 |
| Fax Number: | 5855914204 |
| NPI Enumeration Date: | 08/10/2005 |
| NPI Last Update Date: | 01/28/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 140294 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |