Organization
QUEENS BOULEVARD ASC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AZEEM KHAN MD (OWNER)
(718) 406-8000
Entity
Organization
Contact information
Practice address
9525 QUEENS BLVD, REGO PARK, NY 11374-4510
(718) 406-8000
(929) 214-4425
Mailing address
95-25 QUEENS BOULEVARD, REGO PARK, NY 11374-0000
(718) 406-8000
(929) 214-4425
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/27/2012
Last updated
01/12/2022
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