DR. KHALIL KARDOONI (NPI# 1417043811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417043811 |
| Entity Type | Individual |
| Full Name | DR. KHALIL KARDOONI |
| Credential | M.D. |
| Practice Address |
1571 Washington St Suite 107 Watertown NY 13601-9319 |
| Mailing Address |
1250 Ives St Watertown NY 13601 |
| Practice Telephone | 3157827330 |
| Practice Fax Number | 3157825773 |
| Mailing Telephone | 3157827330 |
| Mailing Fax Number | 3157825773 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2012-09-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 210462 | NY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01870699 | 05 |
| Street Address |
1571 WASHINGTON ST SUITE 107 |
| City | WATERTOWN |
| State | NY |
| Zip Code | 13601-9319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811997042 | Mark Kwalbrun | Radiology | 1571 Washington St, Suite 101, Watertown, NY 13601-9304 | 2005-07-29 |
| 1881018588 | Katherine S. Johnson | Physician Assistant | 1571 Washington St, Suite 104, Watertown, NY 13601-9304 | 2014-02-15 |
| 1710207485 | Joseph C Gianfagna | Specialist | 1571 Washington St, Suite 107, Watertown, NY 13601 | 2010-06-04 |
| 1366608846 | Alyssa J Gibbs | Physical Therapist | 1571 Washington St, Suite 201, Watertown, NY 13601-9304 | 2008-08-04 |
| 1184882243 | Barratt Matthew Schultz | Physician Assistant | 1571 Washington St, Suite 201, Watertown, NY 13601-9304 | 2008-05-27 |
| 1720274657 | Myla D Estepa | Pediatrics | 1571 Washington St, Ste 107, Watertown, NY 13601-9219 | 2007-09-25 |
| 1376749887 | Edward Choung | Orthopaedic Surgery | 1571 Washington St, Suite 201, Watertown, NY 13601-9304 | 2007-06-22 |
| 1437243854 | Alfred Libero Gianfagna | Specialist | 1571 Washington St, Suite 107, Watertown, NY 13601-9319 | 2006-10-02 |
| 1104840826 | John Joseph Wasenko | Radiology | 1571 Washington St, Suite 101, Watertown, NY 13601-9304 | 2006-07-26 |
| 1750318705 | Watertown Pediatrics,pc | Specialist | 1571 Washington St, Suite 107, Watertown, NY 13601-9304 | 2006-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801414156 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 122 Court Street, Empsall Bldg, Room 212, Watertown, NY 13601 | 2020-07-13 |
| 1083231377 | Katherine Anne Cahill | Counselor | 22679 Duffy Road, Watertown, NY 13601 | 2020-07-02 |
| 1851855431 | Hanna Kearney | Physical Therapist | 20053 Summit View Blvd Ste 2, Watertown, NY 13601 | 2019-01-28 |
| 1578039905 | North Country Counseling Services LLC | Counselor | 210 Court St. Suite 4, Watertown, NY 13601 | 2018-10-24 |
| 1073004388 | Megan Anna O'brien | Counselor | 221 S Rutland Street, Watertown, NY 13601 | 2018-05-22 |
| 1558860536 | Kimberly Lynne Amelio | Specialist | 24850 Hinds Rd, Watertown, NY 13601 | 2018-02-06 |
| 1952840050 | Alberto Gonzalez | Social Worker | 211 Jb Wise Plaza, Watertown, NY 13601 | 2017-02-22 |
| 1073967386 | Amanda Pisarski | Licensed Practical Nurse | 26713 Nys Rte 12, Watertown, NY 13601 | 2016-04-22 |
| 1396137709 | Daniel Ernest Morgan | Neuromusculoskeletal Medicine & OMM | 21101 Ny-12f, Building 2, Suite 7, Watertown, NY 13601 | 2015-02-21 |
| 1568868131 | Megan E. Zamora | Dental Hygienist | 14652-b Cedar Way, Watertown, NY 13601 | 2014-11-10 |
| Find all providers in zip 13601 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144884172 | Cheryl Lou Martin | Specialist | 732 Gotham St, Watertown, NY 13601-4008 | 2019-04-25 |
| 1558860536 | Kimberly Lynne Amelio | Specialist | 24850 Hinds Rd, Watertown, NY 13601 | 2018-02-06 |
| 1508241878 | Upstate Radiology, PC | Specialist | 1116 Arsenal St Ste 504, Watertown, NY 13601-2229 | 2015-07-28 |
| 1730563396 | Shannon Marie Foy | Specialist | 20104 Arsenal Street Rd, Watertown, NY 13601-5555 | 2015-07-14 |
| 1235525007 | Julie Choate | Specialist | 11660 Deegan Ave Se, Watertown, MN 55388-8306 | 2015-04-08 |
| 1437554987 | Kelly Grass | Specialist | 449 Cross St, Watertown, NY 13601-3214 | 2014-10-27 |
| 1942550934 | Krista Lynn Iannetta | Specialist | 16783 Ives Street Road, Watertown, NY 13601 | 2012-09-17 |
| 1639430739 | Wendy Mccormick | Specialist | 120 Washington St Ste 306, Watertown, NY 13601-3330 | 2012-06-05 |
| 1285962407 | Ana Laura Stuart | Specialist | 50 Watertown St, #214, Watertown, MA 02472-2542 | 2009-11-29 |
| 1619201795 | Cassandra Marie Ladd-bashford | Specialist | 19472 Us Rt 11, Watertown, NY 13601 | 2009-09-23 |
| Find all providers in WATERTOWN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.