Individual
DR. INTAZAM UDDIN KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2531 30TH RD, SUITE 1F, ASTORIA, NY 11102-2647
(718) 267-8510
(718) 267-8511
Mailing address
2 CAPRI DR, ROSLYN, NY 11576-3205
(718) 267-8510
(718) 267-8511
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
208065
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00246075
—
NY
Enumeration date
09/28/2006
Last updated
12/15/2011
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