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General NPI Number Information
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NPI Number | 1790610996
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Entity Type | Individual
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Provider Name | SUHARTO KHAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/17/2026
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Last Update Date | 06/17/2026
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Provider Practice Location Address
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Address Line | 506 LENOX AVE
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City | NEW YORK
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State | NY
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Zip | 10037-1889
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Country | US
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Telephone | 212-939-2291
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Fax |
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Provider Business Mailing Address
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Address Line | 4730 PINE ST APT C3
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City | PHILADELPHIA
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State | PA
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Zip | 19143-1844
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Country | US
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Telephone | 814-954-9329
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Fax |
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | NA
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License Number State | NY
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