MUSTAFA KEZAR KHOKHA (NPI# 1588604052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588604052 |
Entity Type | Individual |
Full Name | MUSTAFA KEZAR KHOKHA |
Credential | MD |
Practice Address |
800 Howard Ave Yale Physicians Bldg New Haven CT 06519-1369 |
Mailing Address |
300 George St Po Box 9805 New Haven CT 06511-6624 |
Practice Telephone | 2037852140 |
Practice Fax Number | 2037856414 |
Mailing Telephone | 2037857998 |
Mailing Fax Number | 2037856414 |
Enumeration Date | 2006-06-06 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | X |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
044262 | CT | Allopathic & Osteopathic Physicians |
Street Address |
800 HOWARD AVE YALE PHYSICIANS BLDG |
City | NEW HAVEN |
State | CT |
Zip Code | 06519-1369 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184621419 | John P Fulkerson | Orthopaedic Surgery | 800 Howard Ave, New Haven, CT 06519-1369 | 2005-07-01 |
1467068163 | Catherine Aileen Chagnon | Physical Medicine & Rehabilitation | 800 Howard Ave, New Haven, CT 06519-1369 | 2020-09-17 |
1508408915 | Rebecca Lynne Tallarita | Nurse Practitioner | 800 Howard Ave, New Haven, CT 06519 | 2019-10-17 |
1598323610 | Brianne Krawczyk | Pharmacist | 800 Howard Ave, Hvc Center-2nd Floor, New Haven, CT 06519 | 2019-06-04 |
1467017277 | Gabriel B Lerner | Student in an Organized Health Care Education/Training Program | 800 Howard Ave, New Haven, CT 06519-1369 | 2019-05-07 |
1467915413 | Sarah Elizabeth Savoia | Physician Assistant | 800 Howard Ave, New Haven, CT 06519-1369 | 2019-04-08 |
1992287577 | Brittany Cyr | Pharmacist | 800 Howard Ave, New Haven, CT 06519-1369 | 2018-08-30 |
1700395506 | Lauren Katherine Fagan | Audiologist | 800 Howard Ave, New Haven, CT 06519-1369 | 2017-09-25 |
1548784093 | Megan Frank Harari | Nurse Practitioner | 800 Howard Ave, Ste 1st Floor, Room 133, New Haven, CT 06519 | 2017-07-26 |
1942723168 | Jamie B Freeman | Physician Assistant | 800 Howard Ave, Yale Neurosurgery, New Haven, CT 06519-1369 | 2017-07-19 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255819348 | Jordan Ficocelli | Nurse Practitioner | 800 Howard Ave # 2, New Haven, CT 06519 | 2018-08-01 |
1780123414 | Claire Louise Hardin | General Acute Care Hospital | 95 Howard Ave, New Haven, CT 06519 | 2017-02-14 |
1467809137 | Ana Laura Vives-rodriguez | Student in an Organized Health Care Education/Training Program | 800 Howard Avenue, Lower Level, Yale Physicians Building, New Haven, CT 06519 | 2016-05-23 |
1346607785 | Amanda Kayte Corcoran | Advanced Practice Midwife | 40 Prince St., Suite 207, New Haven, CT 06519 | 2016-01-15 |
1720491905 | Sara Harcharik Perkins | Dermatology | 2 Church St S Ste 305, New Haven, CT 06519 | 2014-06-05 |
1194136713 | Krishan Ratilal Jethwa | Radiology | 35 Park St Ste Ll507, New Haven, CT 06519 | 2014-05-16 |
1235549353 | Brandon Michael Kitay | Psychiatry & Neurology | 184 Liberty St # Lv108, New Haven, CT 06519 | 2014-04-28 |
1649526617 | Yale New Haven Hospital | Student in an Organized Health Care Education/Training Program | 330 Cedar St Fmb 107, Yale New Haven Hospital, Dept of Surgery, New Haven, CT 06519 | 2012-07-27 |
1669736765 | Mayanka Tickoo | Internal Medicine | 300 Cedar St Fl 4, New Haven, CT 06519 | 2012-07-03 |
1730441627 | Judith A Ross | Physical Therapist | 18 Tower Lane, Tower One Tower East, New Haven, CT 06519 | 2012-06-15 |
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Taxonomy Code | 2080P0203X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Pediatric Critical Care Medicine |
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477088235 | Marie Nader | Pediatrics | 20 York St, New Haven, CT 06510-3220 | 2017-04-28 |
1821338377 | Samira Neshat Vahid | Pediatrics | 20 York St, Tompkins 209, New Haven, CT 06510-3220 | 2013-02-20 |
1093073959 | Nina N. Brodsky | Pediatrics | 20 York St, Ynhh Department of Pediatrics, New Haven, CT 06510-3220 | 2012-04-30 |
1306116389 | Jose Manuel Panisello | Pediatrics | 20 York St, 305 Lci, New Haven, CT 06510-3220 | 2012-01-06 |
1538397450 | Engin Deniz | Pediatrics | 20 York St, T-209 Yale New Haven Hospital, New Haven, CT 06510-3220 | 2009-06-30 |
1700029238 | Michael Clinton Hooper | Pediatrics | 333 Cedar St, New Haven, CT 06510-3206 | 2009-04-14 |
1407867096 | Troy E Dominguez | Pediatrics | 15 York St, New Haven, CT 06510-3221 | 2006-08-10 |
1487609756 | Stephanie Sudikoff | Pediatrics | 333 Cedar St, Pediatrics/yale University, New Haven, CT 06510-3206 | 2006-05-24 |
1407810831 | John Sebastian Giuliano Jr. | Pediatrics | 20 York St, Pediatric Critical Care, New Haven, CT 06520 | 2006-04-13 |
1316907991 | George Lister Jr. | Pediatrics | 333 Cedar St, New Haven, CT 06510-3206 | 2006-03-27 |
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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.