Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 283814-1 | NY |
NPI | 1144668864 |
---|---|
Provider Name | Dr. Zeeshan Alam Khan |
First Address | Oceanside, NY 11572-1420 |
Second Address | Oceanside, NY 11572-1420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2013 |
Last Update Date | 02/08/2016 |