Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 236644 | NY |
NPI | 1043381791 |
---|---|
Provider Name | Dr. Sami U Khan |
First Address | Stony Brook, NY 11794-0001 |
Second Address | Setauket, NY 11733-3453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H64966 | (02) | NY |