Provider Demographics
NPI:1417276726
Name:KHAN, NAJMUL HASAN (DO)
Entity Type:Individual
Prefix:DR
First Name:NAJMUL
Middle Name:HASAN
Last Name:KHAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:227 RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:LACKAWANNA
Mailing Address - State:NY
Mailing Address - Zip Code:14218
Mailing Address - Country:US
Mailing Address - Phone:716-822-5944
Mailing Address - Fax:171-691-3721
Practice Address - Street 1:397 LOUISIANA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14204-2275
Practice Address - Country:US
Practice Address - Phone:716-480-5272
Practice Address - Fax:716-961-3765
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY267792207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03582143Medicaid