Healthcare Provider Details

I. General information

NPI: 1033569801
Provider Name (Legal Business Name): FARIHA KHAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2016
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 BROAD ST
MILFORD CT
06460-3273
US

IV. Provider business mailing address

1 DAKOTA DR STE 105
NEW HYDE PARK NY
11042-1136
US

V. Phone/Fax

Practice location:
  • Phone: 203-783-0543
  • Fax: 203-874-5782
Mailing address:
  • Phone: 516-608-6800
  • Fax: 516-608-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number303369
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number73955
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: