1003042029 NPI number — AFRASYAB KHAN

Table of content: AFRASYAB KHAN (NPI 1003042029)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003042029 NPI number — AFRASYAB KHAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHAN
Provider First Name:
AFRASYAB
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003042029
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
AFRASYAB KHAN, HOUSE 97, STREET 2, K3,
Provider Second Line Business Mailing Address:
PHASE 3, HAYATABAD.
Provider Business Mailing Address City Name:
PESHAWAR
Provider Business Mailing Address State Name:
NWFP
Provider Business Mailing Address Postal Code:
25000
Provider Business Mailing Address Country Code:
PK
Provider Business Mailing Address Telephone Number:
0092915826827
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1600 SW ARCHER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32610-3003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-265-0680
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/04/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  TRN13667 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: TRN13667 . This is a "TRN NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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