Khlat, Mickel L
Khlat, Mickel L is an individual health care provider with primary practice located at 640 Hawkins Ave , Lake Ronkonkoma NY 11779-2324. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Khlat, Mickel L can be contacted via phone (631) 737-0100.Contact Information
Primary practice address
640 Hawkins Ave
Lake Ronkonkoma NY 11779-2324
Phone: (631) 737-0100
Fax: (631) 417-1117
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 228341 | New York |
Profile Details
| NPI number | 1548288954 |
|---|---|
| LBN Legal business name | Khlat, Mickel L |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Sep 19th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548288954 | NPPES |
| New York | MEDICAID | 02666562 |
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