Provider Demographics
NPI:1659390540
Name:KHAN, KHURRAM H (DPM)
Entity Type:Individual
Prefix:DR
First Name:KHURRAM
Middle Name:H
Last Name:KHAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22433
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-2433
Mailing Address - Country:US
Mailing Address - Phone:215-777-5808
Mailing Address - Fax:215-777-5716
Practice Address - Street 1:148 N 8TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:215-238-6600
Practice Address - Fax:215-922-1706
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006786213E00000X
NY006162213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1033111500001Medicaid
NYPK949P0071OtherMEDICARE ID(FCNY)
TX8D0036Medicare ID - Type UnspecifiedPROVIDER NO.
NYV02936Medicare UPIN
NYPK9491Medicare PIN