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NPI Code Detail

MEDICARE: DR. TARIQ RAFIQ KHAN M.D

MEDICARE: DR. TARIQ RAFIQ KHAN 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
1208000000XPediatrics Physician182356NY

General Provider Information

NPI Number : 1750608899
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TARIQ RAFIQ KHAN M.D
Provider Business Mailing Address
First Line : 15 WOODSTONE DR
Second Line :
City : VOORHEES
State : NJ
Zip : 08043-4735
Country : US
Telephone Number : 856-745-3650
Fax Number :
Provider Business Practice Location Address
First Line : 817 E 180TH ST
Second Line :
City : BRONX
State : NY
Zip : 10460-1305
Country : US
Telephone Number : 718-220-8300
Fax Number : 718-220-8330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2010
Last Update Date : 04/29/2010

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