Provider Demographics
NPI:1750606885
Name:KHAN, TUFAIL AHMED (RPH)
Entity type:Individual
Prefix:
First Name:TUFAIL
Middle Name:AHMED
Last Name:KHAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4216 80TH ST APT 3L
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3011
Mailing Address - Country:US
Mailing Address - Phone:917-705-9052
Mailing Address - Fax:
Practice Address - Street 1:1515 HAZEN ST
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1395
Practice Address - Country:US
Practice Address - Phone:718-546-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042866-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist