Provider Demographics
NPI:1750660924
Name:KHAN, IRFANA (MD)
Entity Type:Individual
Prefix:DR
First Name:IRFANA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 EASTON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1750
Mailing Address - Country:US
Mailing Address - Phone:908-666-2826
Mailing Address - Fax:908-336-8399
Practice Address - Street 1:222 EASTON AVE STE B
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1750
Practice Address - Country:US
Practice Address - Phone:908-666-2826
Practice Address - Fax:908-336-8399
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09007600208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0278611Medicaid