1649917501 NPI number — MR. GEORGES KHATTAR M.D.

Table of content: MR. GEORGES KHATTAR M.D. (NPI 1649917501)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649917501 NPI number — MR. GEORGES KHATTAR M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHATTAR
Provider First Name:
GEORGES
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649917501
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
01/04/2023
NPI Reactivation Date:
03/01/2023

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
475 SEAVIEW AVENUE, STATEN ISLAND UNIVERSITY HOSPITAL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STATEN ISLAND
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-226-8312
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13400 E SHEA BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85259-5499
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-301-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/12/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  R81463 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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