Provider Demographics
NPI:1437393063
Name:KHAN, HABIB (MD)
Entity Type:Individual
Prefix:
First Name:HABIB
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 1:3700 ROUTE 33
Mailing Address - Street 2:2ND FLOOR-SUITE C
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-3268
Mailing Address - Country:US
Mailing Address - Phone:732-212-6598
Mailing Address - Fax:732-922-2026
Practice Address - Street 1:3700 ROUTE 33
Practice Address - Street 2:2ND FLOOR-SUITE C
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-3268
Practice Address - Country:US
Practice Address - Phone:732-212-6598
Practice Address - Fax:732-922-2026
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-27
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA096931002086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery