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General NPI Number Information
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NPI Number | 1164544623
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Entity Type | Organization
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Legal Business Name | NATIONAL WOUND CARE CONSULTANTS
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 509 SUSSEX RD
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City | WOOD RIDGE
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State | NJ
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Zip | 07075-1305
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Country | US
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Telephone | 201-321-8970
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Fax |
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Provider Business Mailing Address
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Address Line | 509 SUSSEX RD
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City | WOOD RIDGE
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State | NJ
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Zip | 07075-1305
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | DR. KHURRAM KHAN
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Credential | DPM
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Telephone | 201-321-8970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 25MD00290700
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License Number State | NJ
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