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Individual

DR. RIZWAN KHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
840 HANSHAW RD, ITHACA, NY 14850
(607) 257-6563
Mailing address
840 HANSHAW RD, ITHACA, NY 14850-1589
(607) 257-6563

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
2000-219
NM
208000000X
Pediatrics Physician
2000-219
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000G9234
NM
Enumeration date
01/09/2006
Last updated
09/19/2011
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