Provider Demographics
NPI:1982789012
Name:KHAN, NAZ (MD)
Entity Type:Individual
Prefix:
First Name:NAZ
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 1:3514 72ND ST
Mailing Address - Street 2:APT. 2B
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-4037
Mailing Address - Country:US
Mailing Address - Phone:718-829-6770
Mailing Address - Fax:718-904-9145
Practice Address - Street 1:MMG - CASTLE HILL
Practice Address - Street 2:2175 WESTCHESTER AVENUE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462
Practice Address - Country:US
Practice Address - Phone:718-829-6770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238766207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine