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General NPI Number Information
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NPI Number | 1184145765
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Entity Type | Individual
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Provider Name | AMNA KHAN MD
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Gender | Female
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Dates
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Enumeration Date | 07/04/2017
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Last Update Date | 05/16/2024
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Provider Practice Location Address
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Address Line | 111 SALEM TPKE STE 8
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City | NORWICH
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State | CT
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Zip | 06360-7403
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Country | US
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Telephone | 860-886-0023
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Fax | 860-886-0024
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Provider Business Mailing Address
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Address Line | 1290 SILAS DEANE HWY
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City | WETHERSFIELD
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State | CT
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Zip | 06109-4337
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Country | US
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Telephone | 860-972-9034
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Fax | 860-972-7040
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 76050
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License Number State | CT
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