Healthcare Provider Details

I. General information

NPI: 1326625245
Provider Name (Legal Business Name): SANA IRFAN KHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 03/21/2026
Certification Date: 03/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 PARSONS BLVD
FLUSHING NY
11355-2205
US

IV. Provider business mailing address

7439 CALAMUS CIR APT 3
ELMHURST NY
11373-4471
US

V. Phone/Fax

Practice location:
  • Phone: 929-235-4139
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number330906
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: