1144326034 NPI number — DR. NAHEED A KHAN MD

Table of content: DR. NAHEED A KHAN MD (NPI 1144326034)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144326034 NPI number — DR. NAHEED A KHAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHAN
Provider First Name:
NAHEED
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1144326034
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/11/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 712
Provider Second Line Business Mailing Address:
167 NEW JERSEY AVE
Provider Business Mailing Address City Name:
ABSECON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-927-7100
Provider Business Mailing Address Fax Number:
609-927-7103

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 NEW RD
Provider Second Line Business Practice Location Address:
SUITE 1B
Provider Business Practice Location Address City Name:
LINWOOD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08221-1121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-927-7100
Provider Business Practice Location Address Fax Number:
609-927-7103
Provider Enumeration Date:
09/16/2006

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: 2081P2900X , with the licence number:  25MA03409800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4525993 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61588 . This is a "AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1108388 . This is a "HORIZON MERCY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 91000516500 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1572903 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: P3629744 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0047457 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2367314000 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".




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