Provider Demographics
NPI:1780695528
Name:KHAN, ZAHIDA (MD)
Entity type:Individual
Prefix:DR
First Name:ZAHIDA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 WENTWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507
Mailing Address - Country:US
Mailing Address - Phone:718-386-3062
Mailing Address - Fax:516-294-4558
Practice Address - Street 1:115 IRVING AVE
Practice Address - Street 2:RIDGEWOOD MEDICAL AND DENTAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-8024
Practice Address - Country:US
Practice Address - Phone:718-386-3062
Practice Address - Fax:718-386-2402
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1482741208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0066104Medicaid
NY0066104Medicaid
NYF008009Medicare UPIN
NY0066104Medicaid