Provider Demographics
NPI:1336192509
Name:KHAN, SAQIBA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAQIBA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:80 MARCUS DRIVE
Mailing Address - Street 2:JAMAICA HOSPITAL EMERGENCY DEPT
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747
Mailing Address - Country:US
Mailing Address - Phone:631-391-7700
Mailing Address - Fax:631-454-4161
Practice Address - Street 1:8900 VAN WYCK EXPY
Practice Address - Street 2:JAMAICA HOSPITAL EMERGENCY DEPT
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11418-2897
Practice Address - Country:US
Practice Address - Phone:718-206-6000
Practice Address - Fax:631-454-4161
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07535600208000000X
NY225172207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02360158Medicaid
NYH81237Medicare UPIN