Individual
MUSTAFA ALI KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
33-57 HARRISON ST, JOHNSON CITY, NY 13790-2107
(607) 763-6412
Mailing address
33 LEWIS RD, FL 2, BINGHAMTON, NY 13905
(607) 770-0025
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
333172
NY
Other
Enumeration date
04/18/2021
Last updated
09/30/2024
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