MEDICARE: ADAM ZAFAR KHAN PA

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	017320	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	017320	OTHER	NY	NEW YORK STATE EDUCATION DEPARTMENT

General Provider Information

NPI Number	:	1407251093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM ZAFAR KHAN PA

Provider Business Mailing Address
First Line	:	8541 105TH ST
Second Line	:
City	:	RICHMOND HILL
State	:	NY
Zip	:	11418-1128
Country	:	US
Telephone Number	:	718-805-2643
Fax Number	:

Provider Business Practice Location Address
First Line	:	8541 105TH ST
Second Line	:
City	:	RICHMOND HILL
State	:	NY
Zip	:	11418-1128
Country	:	US
Telephone Number	:	718-805-2643
Fax Number	:

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

Provider Enumeration Date	:	10/26/2014
Last Update Date	:	10/26/2014

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Directions to “ ADAM ZAFAR KHAN PA” Practice Location

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