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NPI Code Detail

MEDICARE: DR. RIZWAN KHAN M.D.

MEDICARE: DR. RIZWAN KHAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician2000-219NM
2207K00000XAllergy & Immunology Physician2000-219NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700864881
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RIZWAN KHAN M.D.
Provider Business Mailing Address
First Line : 904 E SHORE DR
Second Line :
City : ITHACA
State : NY
Zip : 14850-1026
Country : US
Telephone Number : 607-257-6563
Fax Number :
Provider Business Practice Location Address
First Line : 904 E SHORE DR
Second Line :
City : ITHACA
State : NY
Zip : 14850-1026
Country : US
Telephone Number : 607-257-6563
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2006
Last Update Date : 06/08/2026

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