Individual
KHADIJA KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 SAINT ANDREWS LN, GLEN COVE, NY 11542-2254
(516) 674-7631
(516) 674-7639
Mailing address
101 SAINT ANDREWS LN, GLEN COVE, NY 11542-2254
(516) 674-7631
(516) 674-7639
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
325619
NY
Other
Enumeration date
03/31/2020
Last updated
05/02/2024
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