Individual
IRM KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
353 MAIN ST, MANCHESTER, CT 06040-4145
(860) 649-3477
Mailing address
75 REDWOOD DR, #610, EAST HAVEN, CT 06513-1970
(203) 468-1982
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001833
CT
Other
Enumeration date
04/25/2007
Last updated
07/08/2007
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