Provider Demographics
NPI:1174256218
Name:KHAN, ATIF IRFAN (MBBS)
Entity Type:Individual
Prefix:
First Name:ATIF
Middle Name:IRFAN
Last Name:KHAN
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 NORTHERN BOULEVARD, ENTRANCE A
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GREENVALE
Mailing Address - State:NY
Mailing Address - Zip Code:11548
Mailing Address - Country:US
Mailing Address - Phone:516-304-7234
Mailing Address - Fax:
Practice Address - Street 1:1111 MARCUS AVENUE ZUCKER SCHOOL OF MEDICINE AT HOFSTRA
Practice Address - Street 2:SUITE 107, NEW HYDE PARK
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:516-304-7234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2023-03-23
Deactivation Date:2023-03-16
Deactivation Code:
Reactivation Date:2023-03-23
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program