MEDICARE: SARA KHAN RPA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	028614	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235887647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA KHAN RPA-C

Provider Business Mailing Address
First Line	:	1 CAMPUS RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-4479
Country	:	US
Telephone Number	:	718-390-3100
Fax Number	:

Provider Business Practice Location Address
First Line	:	57 BAY ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-2510
Country	:	US
Telephone Number	:	855-681-8700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2022
Last Update Date	:	03/03/2026

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Directions to “ SARA KHAN RPA-C” Practice Location

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