Organization
FRONT STREET MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID G KHANAN MD (PRESIDENT)
(516) 565-4370
Entity
Organization
Contact information
Practice address
11045 QUEENS BLVD, SUITE AA, FOREST HILLS, NY 11375-5501
(718) 268-4468
Mailing address
717 FRONT ST, HEMPSTEAD, NY 11550-4534
(516) 565-4370
(516) 565-2644
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
228173
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
228173
MED LIC
NY
Enumeration date
05/17/2007
Last updated
08/22/2020
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