Healthcare Provider Details

I. General information

NPI: 1053414169
Provider Name (Legal Business Name): ZAFAR A. KHAN M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 WOODBOURNE RD 202 B
LEVITTOWN PA
19057-1500
US

IV. Provider business mailing address

1609 WOODBOURNE RD 202 B
LEVITTOWN PA
19057-1500
US

V. Phone/Fax

Practice location:
  • Phone: 215-949-8300
  • Fax: 215-949-8301
Mailing address:
  • Phone: 215-949-8300
  • Fax: 215-949-8301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD070945L
License Number StatePA

VIII. Authorized Official

Name: ZAFAR ALI KHAN
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 215-949-8300