Provider Demographics
NPI:1093794661
Name:KHAN, MOHAMMED ASLAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:ASLAM
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-5707
Mailing Address - Country:US
Mailing Address - Phone:718-748-2900
Mailing Address - Fax:718-748-9365
Practice Address - Street 1:263 7TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3689
Practice Address - Country:US
Practice Address - Phone:718-832-1818
Practice Address - Fax:718-832-6125
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY195507207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01669263Medicaid
NY10N041Medicare ID - Type Unspecified
NYG29441Medicare UPIN