Provider Demographics
NPI:1265647150
Name:KHAN, NABEEL (MD)
Entity Type:Individual
Prefix:
First Name:NABEEL
Middle Name:
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 1:1561 LONG POND RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4117
Mailing Address - Country:US
Mailing Address - Phone:585-723-7670
Mailing Address - Fax:585-723-7671
Practice Address - Street 1:2865 N REYNOLDS RD STE 250
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-2070
Practice Address - Country:US
Practice Address - Phone:419-534-6551
Practice Address - Fax:419-534-6563
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2494772086S0122X
OH35.1299552086S0122X, 208200000X
MI43010795442086S0122X, 208200000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery