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General NPI Number Information
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NPI Number | 1639428287
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Entity Type | Organization
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Legal Business Name | SAJID KHAN MD PC
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 08/29/2012
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Provider Practice Location Address
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Address Line | 10 MEDICAL PLZ SUITE 303
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City | GLEN COVE
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State | NY
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Zip | 11542-2101
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Country | US
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Telephone | 516-430-1671
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3609
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-8609
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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 | MD
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Name | MR. SAJID KHAN
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Credential |
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Telephone | 516-430-1671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 253659
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License Number State | NY
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