| A Khan Physician Pc | |
|
187 Dot Ct E Oceanside NY 11572-5920 | |
| (516) 404-1660 | |
| (516) 404-1660 |
| Full Name | A Khan Physician Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 187 Dot Ct E, Oceanside, New York |
| Authorized Official Name and Position | Diane Valva (OFFICE MANAGER) |
| Authorized Official Contact | 5167643310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Khan Physician Pc 187 Dot Ct E Oceanside NY 11572-5920 Ph: (516) 404-1660 | A Khan Physician Pc 187 Dot Ct E Oceanside NY 11572-5920 Ph: (516) 404-1660 |
| NPI Number | 1710491592 |
|---|---|
| Provider Enumeration Date | 12/01/2017 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 8628313616 |
|---|---|
| Medicare Enrollment ID | O20181219002115 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710491592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Aijaz Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912984063 PECOS PAC ID: 7911944350 Enrollment ID: I20050421001596 |
| Provider Name | Jennifer Stephanie Egbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992244321 PECOS PAC ID: 4183972839 Enrollment ID: I20180813001370 |
| Provider Name | Laura R Chase |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215436886 PECOS PAC ID: 7315283819 Enrollment ID: I20190103002055 |
| Provider Name | Sherry Xie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598315087 PECOS PAC ID: 4486082724 Enrollment ID: I20200319001207 |
| Provider Name | Gurpreet Kaur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730797861 PECOS PAC ID: 9830518927 Enrollment ID: I20200923000174 |
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