Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 225172 | NY |
N | 208000000X | Pediatrician | 25MA07535600 | NJ |
NPI | 1336192509 |
---|---|
Provider Name | Dr. Saqiba Khan |
First Address | Melville, NY 11747 |
Second Address | Jamaica, NY 11418-2897 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 11/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02360158 | (05) | NY |
H81237 | (02) | NY |