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NPI Code Detail

MEDICARE: DR. TAHA FATHIMA KHAN M.D.

MEDICARE: DR. TAHA FATHIMA 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
12084N0402XNeurology with Special Qualifications in Child Neurology Physician334835NY

General Provider Information

NPI Number : 1962021089
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TAHA FATHIMA KHAN M.D.
Provider Business Mailing Address
First Line : 100 WILLOUGHBY ST APT 9B
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-4935
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4802 10TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-2916
Country : US
Telephone Number : 718-283-8884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2020
Last Update Date : 07/03/2025

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