Provider Demographics
NPI:1184976631
Name:KHAN MEDICAL ASSOCIATE
Entity type:Organization
Organization Name:KHAN MEDICAL ASSOCIATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:Q
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-242-8860
Mailing Address - Street 1:208 SEIGFRIED STREET
Mailing Address - Street 2:PO BOX 206
Mailing Address - City:ARONA
Mailing Address - State:PA
Mailing Address - Zip Code:15617
Mailing Address - Country:US
Mailing Address - Phone:724-217-0782
Mailing Address - Fax:
Practice Address - Street 1:200 PENN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-2156
Practice Address - Country:US
Practice Address - Phone:412-242-8860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012275282N00000X, 3140N1450X, 315D00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No282N00000XHospitalsGeneral Acute Care Hospital
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient