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General NPI Number Information
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NPI Number | 1508958471
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Entity Type | Individual
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Provider Name | AMBER MANZOOR KHAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 12/19/2012
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Provider Practice Location Address
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Address Line | 1500 MOUNTAIN TOP RD
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-1837
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Country | US
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Telephone | 908-522-1313
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Fax | 908-522-1302
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Provider Business Mailing Address
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Address Line | 1500 MOUNTAIN TOP RD
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-1837
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Country | US
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Telephone | 908-522-1313
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Fax | 908-522-1302
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 25MA07209000
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License Number State | NJ
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