Provider Demographics
NPI:1972580835
Name:KHAN, NOROZE J (MD)
Entity Type:Individual
Prefix:DR
First Name:NOROZE
Middle Name:J
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NOROZE
Other - Middle Name:JALIL
Other - Last Name:KHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:20 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-2933
Mailing Address - Country:US
Mailing Address - Phone:201-963-3570
Mailing Address - Fax:201-526-0461
Practice Address - Street 1:20 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-2933
Practice Address - Country:US
Practice Address - Phone:201-963-3570
Practice Address - Fax:201-526-0461
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-30
Last Update Date:2017-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04209600207RI0200X
NJMA04209660207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3611400Medicaid
D06788Medicare UPIN
NJ3611400Medicaid