Provider Demographics
NPI:1780703298
Name:KHAN, SAJJAD ALI (MD)
Entity type:Individual
Prefix:DR
First Name:SAJJAD
Middle Name:ALI
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25 ZABRISKIE ST APT 2D
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-4939
Mailing Address - Country:US
Mailing Address - Phone:201-362-5710
Mailing Address - Fax:718-466-6060
Practice Address - Street 1:1276 FULTON AVE # 4S
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-3402
Practice Address - Country:US
Practice Address - Phone:718-590-1800
Practice Address - Fax:718-466-6060
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY238369101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional