Provider Demographics
NPI:1033569801
Name:KHAN, FARIHA (DO)
Entity Type:Individual
Prefix:
First Name:FARIHA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DAKOTA DR STE 105
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1136
Mailing Address - Country:US
Mailing Address - Phone:516-608-6800
Mailing Address - Fax:516-608-6801
Practice Address - Street 1:247 BROAD ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3273
Practice Address - Country:US
Practice Address - Phone:203-783-0543
Practice Address - Fax:203-874-5782
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-13
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303369207V00000X
390200000X
CT73955207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program