MEDICARE: DR. KHUDSIA RANA IRFAN M.D.

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	208000000X	Pediatrics Physician	235147	NY

General Provider Information

NPI Number	:	1538227483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KHUDSIA RANA IRFAN M.D.

Provider Business Mailing Address
First Line	:	21 SHOREVIEW DR
Second Line	:	APT. # 1
City	:	YONKERS
State	:	NY
Zip	:	10710-1948
Country	:	US
Telephone Number	:	914-573-9107
Fax Number	:

Provider Business Practice Location Address
First Line	:	2432 GRAND CONCOURSE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10458-5204
Country	:	US
Telephone Number	:	718-817-7913
Fax Number	:

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

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	07/08/2007

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