MEDICARE: DR. SHER KHAN

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	183500000X	Pharmacist	064843-1	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	:	1851860035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHER KHAN

Provider Business Mailing Address
First Line	:	1704 OCEAN AVE APT 2H
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-5777
Country	:	US
Telephone Number	:	646-740-4858
Fax Number	:

Provider Business Practice Location Address
First Line	:	1672 PITKIN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-5605
Country	:	US
Telephone Number	:	347-627-4778
Fax Number	:

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

Provider Enumeration Date	:	11/18/2018
Last Update Date	:	01/15/2020

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