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NPI Code Detail

MEDICARE: FARAH KHAN

MEDICARE: FARAH KHAN
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
1207QA0401XAddiction Medicine (Family Medicine) Physician
22084P0800XPsychiatry Physician
3208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1710259569
Entity Type Code : Organization
Provider Name (Legal Business Name) : FARAH KHAN
Provider Business Mailing Address
First Line : 4065 QUAKERBRIDGE RD
Second Line :
City : PRINCETON JUNCTION
State : NJ
Zip : 08550-5243
Country : US
Telephone Number : 609-482-3701
Fax Number : 609-482-3702
Provider Business Practice Location Address
First Line : 4065 QUAKERBRIDGE RD
Second Line :
City : PRINCETON JUNCTION
State : NJ
Zip : 08550-5243
Country : US
Telephone Number : 609-482-3701
Fax Number : 609-482-3702
Authorized Official
Title or Position : MANAGER
Name : NAOMI MARY
Credential :
Telephone Number : 609-482-3701
Provider Enumeration Date : 02/08/2012
Last Update Date : 02/08/2012

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