Individual
LUTFA KHANAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1855 MOTT AVE, FAR ROCKAWAY, NY 11691-4201
(718) 868-8282
(718) 471-2865
Mailing address
1855 MOTT AVE, FAR ROCKAWAY, NY 11691-4201
(718) 868-8282
(718) 471-2865
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
200170
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01797891
—
NY
Enumeration date
11/14/2006
Last updated
06/30/2015
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