MEDICARE: DR. BILAL A. KHAN D.O.

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	208100000X	Physical Medicine & Rehabilitation Physician	266911	NY

General Provider Information

NPI Number	:	1790073088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BILAL A. KHAN D.O.

Provider Business Mailing Address
First Line	:	12 BEACH HILL DR
Second Line	:
City	:	NORTHPORT
State	:	NY
Zip	:	11768-1424
Country	:	US
Telephone Number	:	786-445-0495
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 MORICHES RD
Second Line	:
City	:	SAINT JAMES
State	:	NY
Zip	:	11780-2150
Country	:	US
Telephone Number	:	631-862-8000
Fax Number	:

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

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	08/28/2019

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