Organization
CLERISY MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GULAM M KHAN M.D. (OWNER)
(718) 840-7142
Entity
Organization
Contact information
Practice address
446 MCDONALD AVE, BROOKLYN, NY 11218-2212
(718) 972-4200
(718) 972-6861
Mailing address
114 TALLEY RD S, ROSLYN, NY 11576-2598
(718) 421-2131
(718) 421-2130
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
228737
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02426433
—
NY
Enumeration date
06/18/2008
Last updated
07/20/2012
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