Provider Demographics
NPI:1023564390
Name:KHALIK, REHAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:REHAN
Middle Name:
Last Name:KHALIK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 STRATFORD GRN
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-2548
Mailing Address - Country:US
Mailing Address - Phone:443-600-4900
Mailing Address - Fax:
Practice Address - Street 1:10095 MAIN RD
Practice Address - Street 2:
Practice Address - City:MATTITUCK
Practice Address - State:NY
Practice Address - Zip Code:11952-1658
Practice Address - Country:US
Practice Address - Phone:631-298-5601
Practice Address - Fax:631-298-3598
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061789183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist