Provider Demographics
NPI:1013975234
Name:KHAN, FAIZ A (MD)
Entity Type:Individual
Prefix:
First Name:FAIZ
Middle Name:A
Last Name:KHAN
Suffix:
Gender:M
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:NASSAU UNIVERSITY MED. CTR. 2201 HEMPSTEAD TPK
Mailing Address - Street 2:MEDICAL STAFF OFFICE BOX 42
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-0854
Mailing Address - Country:US
Mailing Address - Phone:516-572-6175
Mailing Address - Fax:516-572-5465
Practice Address - Street 1:NASSAU UNIVERSITY MED. CTR. 2201 HEMPSTEAD TPK.
Practice Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE G-703
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2360
Practice Address - Country:US
Practice Address - Phone:516-572-6175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211517207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01014210730001Medicaid
NY01014210730001Medicaid
NY96271Medicare PIN