Provider Demographics
NPI:1154585271
Name:KHAN, NAHIDA SULTANA (MD)
Entity type:Individual
Prefix:
First Name:NAHIDA
Middle Name:SULTANA
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3965 52ND ST APT 5E
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3213
Mailing Address - Country:US
Mailing Address - Phone:646-240-1590
Mailing Address - Fax:
Practice Address - Street 1:3500 LATOUCHE ST STE 245A
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4260
Practice Address - Country:US
Practice Address - Phone:646-240-1590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-02392207R00000X
WY10759A207R00000X
CT52854207R00000X
MA289319207RG0300X
MS28900207RG0300X
TXT1413207RG0300X
CODR.0068891207RG0300X
AL42630207RG0300X
OH35.142423207RG0300X
CA171159207RG0300X
NJ25MA10999200207RG0300X
NY267063207RG0300X
IL036.161600207RG0300X
AK175840207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine