Provider Demographics
NPI:1366473654
Name:KHAN, ALIYA W (MD)
Entity Type:Individual
Prefix:
First Name:ALIYA
Middle Name:W
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:856-968-8499
Practice Address - Street 1:651 JOHN F KENNEDY WAY
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1262
Practice Address - Country:US
Practice Address - Phone:609-835-2383
Practice Address - Fax:609-589-3841
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2016-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA07981000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI48508Medicare UPIN
NJ097627Medicare ID - Type Unspecified