Healthcare Provider Details

I. General information

NPI: 1538203690
Provider Name (Legal Business Name): MUHAMMAD J.S.KHAN MD,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4018CASE STREET, MAIN FLOOR
ELMHURST NY
11373
US

IV. Provider business mailing address

15 HIGHVIEW RD
JERSEY CITY NJ
07305-2105
US

V. Phone/Fax

Practice location:
  • Phone: 718-205-7400
  • Fax:
Mailing address:
  • Phone: 718-205-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. MUHAMMAD J.S KHAN
Title or Position: OWNER
Credential: MD
Phone: 718-205-7400