Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 1925931 | NY |
NPI | 1073502019 |
---|---|
Provider Name | Serazul A Khan |
First Address | Binghamton, NY 13905-4246 |
Second Address | Johnson City, NY 13790-2161 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2005 |
Last Update Date | 20/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01445303 | (05) | NY |
F70839 | (02) |