Provider Demographics
NPI:1053439661
Name:NOOR Z KHAN, M.D
Entity type:Organization
Organization Name:NOOR Z KHAN, M.D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NOOR
Authorized Official - Middle Name:Z
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-352-1136
Mailing Address - Street 1:72 NEW HYDE PARK RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-3638
Mailing Address - Country:US
Mailing Address - Phone:516-352-1136
Mailing Address - Fax:718-323-6576
Practice Address - Street 1:72 NEW HYDE PARK RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-3638
Practice Address - Country:US
Practice Address - Phone:516-352-1136
Practice Address - Fax:718-323-6576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160701207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWCW401Medicare ID - Type Unspecified
NYA62329Medicare UPIN