Provider Demographics
NPI:1316160039
Name:KAHN, FREDERICK ELLIOT (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:ELLIOT
Last Name:KAHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-5241
Mailing Address - Country:US
Mailing Address - Phone:201-587-0414
Mailing Address - Fax:201-655-7851
Practice Address - Street 1:6 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5241
Practice Address - Country:US
Practice Address - Phone:201-587-0414
Practice Address - Fax:201-655-7851
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ MA0566152084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJA61289Medicare UPIN