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General NPI Number Information
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NPI Number | 1033186002
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Entity Type | Individual
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Provider Name | SAJID ALI KHAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 08/25/2016
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Provider Practice Location Address
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Address Line | 200 FRONT ST SUITE C
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City | VESTAL
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State | NY
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Zip | 13850-1559
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Country | US
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Telephone | 607-748-7468
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Fax | 607-748-7469
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Provider Business Mailing Address
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Address Line | 46 HARRISON ST
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City | JOHNSON CITY
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State | NY
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Zip | 13790-2120
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Country | US
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Telephone | 607-729-4942
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Fax | 607-729-7516
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | D0064244
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | D0064244
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License Number State | MD
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