Provider Demographics
NPI:1053414169
Name:ZAFAR A. KHAN M.D.
Entity type:Organization
Organization Name:ZAFAR A. KHAN M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZAFAR
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-949-8300
Mailing Address - Street 1:1609 WOODBOURNE RD
Mailing Address - Street 2:202 B
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19057-1500
Mailing Address - Country:US
Mailing Address - Phone:215-949-8300
Mailing Address - Fax:215-949-8301
Practice Address - Street 1:1609 WOODBOURNE RD
Practice Address - Street 2:202 B
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-1500
Practice Address - Country:US
Practice Address - Phone:215-949-8300
Practice Address - Fax:215-949-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070945L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018174090004Medicaid
PA041732Medicare ID - Type Unspecified
PA0018174090004Medicaid