Provider Demographics
NPI:1457676025
Name:KHAN, HAMID R (RPH)
Entity Type:Individual
Prefix:MR
First Name:HAMID
Middle Name:R
Last Name:KHAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:101 HOSPITAL RD
Mailing Address - Street 2:BROOKHAVEN MEMORIAL HOSPITAL, PHARMACY DEPT.
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772
Mailing Address - Country:US
Mailing Address - Phone:631-687-4185
Mailing Address - Fax:631-447-3700
Practice Address - Street 1:101 HOSPITAL RD
Practice Address - Street 2:BROOKHAVEN MEMORIAL HOSPITAL, PHARMACY DEPT.
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772
Practice Address - Country:US
Practice Address - Phone:631-687-4185
Practice Address - Fax:631-447-3700
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY30508183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist