Provider Demographics
NPI:1871685495
Name:KHOKHAR, SHAFIQ REHMAN (MD)
Entity Type:Individual
Prefix:
First Name:SHAFIQ
Middle Name:REHMAN
Last Name:KHOKHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:90 N SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3611
Mailing Address - Country:US
Mailing Address - Phone:718-845-6500
Mailing Address - Fax:718-845-6569
Practice Address - Street 1:9217 101ST AVE
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11416-2316
Practice Address - Country:US
Practice Address - Phone:718-845-6500
Practice Address - Fax:718-845-6569
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2011-06-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2153352084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry