Individual
TAZLEEM SHAZAD KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4250 HEMPSTEAD TPKE STE 17, BETHPAGE, NY 11714-5707
(516) 735-5522
(516) 644-5385
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
276217
NY
207RN0300X
Nephrology Physician
Primary
276217
NY
Other
Enumeration date
03/25/2011
Last updated
11/11/2021
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