Provider Demographics
NPI:1629418850
Name:KHAN, NIDAH TALAL (MD)
Entity Type:Individual
Prefix:DR
First Name:NIDAH
Middle Name:TALAL
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:299 CAREW ST. STE 234
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104
Mailing Address - Country:US
Mailing Address - Phone:413-787-2575
Mailing Address - Fax:413-787-2576
Practice Address - Street 1:98 SHAKER ROAD
Practice Address - Street 2:
Practice Address - City:EAST LONG MEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028
Practice Address - Country:US
Practice Address - Phone:413-798-0301
Practice Address - Fax:413-224-2685
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2022-06-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA257058207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine