Provider Demographics
NPI:1194784074
Name:KHAN, ABU NGA (MD, MSC)
Entity type:Individual
Prefix:DR
First Name:ABU
Middle Name:NGA
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD, MSC
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Mailing Address - Street 1:227 SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-1406
Mailing Address - Country:US
Mailing Address - Phone:718-796-0682
Mailing Address - Fax:
Practice Address - Street 1:622 W 168TH ST PH 260
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-9825
Practice Address - Fax:212-544-1974
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2007322080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01642382Medicaid
NYG24031Medicare UPIN
NY526941Medicare ID - Type Unspecified