Provider Demographics
NPI:1720266992
Name:KHAN, MOHAMMED NAEEM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:NAEEM
Last Name:KHAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HELENA AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-3026
Mailing Address - Country:US
Mailing Address - Phone:914-935-3102
Mailing Address - Fax:
Practice Address - Street 1:1 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-4314
Practice Address - Country:US
Practice Address - Phone:914-935-3102
Practice Address - Fax:914-935-3120
Is Sole Proprietor?:No
Enumeration Date:2008-02-09
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
050486Other050486