Provider Demographics
NPI:1801071840
Name:KHAN, FARAH D (PHARMACIST)
Entity type:Individual
Prefix:MRS
First Name:FARAH
Middle Name:D
Last Name:KHAN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 ROUTE 211 E
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-1413
Mailing Address - Country:US
Mailing Address - Phone:845-692-2422
Mailing Address - Fax:845-692-3778
Practice Address - Street 1:701 ROUTE 211 E
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-1413
Practice Address - Country:US
Practice Address - Phone:845-692-2422
Practice Address - Fax:845-692-3778
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047775-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist