Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 260921 | NY |
NPI | 1013151216 |
---|---|
Provider Name | Tehmina Khan |
First Address | Middletown, NY 10941-4028 |
Second Address | Middletown, NY 10941-4028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2009 |
Last Update Date | 14/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03350378 | (05) | NY |