Provider Demographics
NPI:1992065593
Name:KHAN, SUNNIYA (MB, BS, MD)
Entity type:Individual
Prefix:DR
First Name:SUNNIYA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:MB, BS, MD
Other - Prefix:DR
Other - First Name:SUNNIYA
Other - Middle Name:
Other - Last Name:KHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:10 AUER CT STE 102
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5848
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 AUER CT STE 102
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5848
Practice Address - Country:US
Practice Address - Phone:917-683-2304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09866300208VP0000X
MDD0099469207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine