Provider Demographics
NPI:1043792419
Name:KHAN, NADIA BEGUM (DNP)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:BEGUM
Last Name:KHAN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:NADIA
Other - Middle Name:
Other - Last Name:QAZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1561 LONG POND RD STE 202
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4135
Mailing Address - Country:US
Mailing Address - Phone:585-723-7778
Mailing Address - Fax:585-723-7925
Practice Address - Street 1:1561 LONG POND RD STE 202
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4135
Practice Address - Country:US
Practice Address - Phone:585-723-7778
Practice Address - Fax:585-723-7925
Is Sole Proprietor?:No
Enumeration Date:2018-09-03
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308895363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health