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NPI Code Detail

MEDICARE: DR. AZIZ KHAN DDS

MEDICARE: DR. AZIZ KHAN DDS
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
11223G0001XGeneral Practice Dentistry040670NY

General Provider Information

NPI Number : 1811003908
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AZIZ KHAN DDS
Provider Business Mailing Address
First Line : 1757 NEW YORK AVE
Second Line :
City : HUNTINGTON STATION
State : NY
Zip : 11746-2407
Country : US
Telephone Number : 631-423-6491
Fax Number :
Provider Business Practice Location Address
First Line : 1757 NEW YORK AVE
Second Line :
City : HUNTINGTON STATION
State : NY
Zip : 11746-2407
Country : US
Telephone Number : 631-423-6491
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2006
Last Update Date : 07/08/2007

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