Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | D0064244 | MD |
Y | 2081P2900X | Pain Medicine | D0064244 | MD |
NPI | 1033186002 |
---|---|
Provider Name | Dr. Sajid Ali Khan |
First Address | Johnson City, NY 13790-2120 |
Second Address | Vestal, NY 13850-1559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 25/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I60088 | (02) | MD |