Basic Information
| Provider Information | |||||||||
| NPI: | 1598182032 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHAN | ||||||||
| FirstName: | ABRAR | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 KINGS HWY S | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146175504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5859220553 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1425 PORTLAND AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5859225067 | ||||||||
| FaxNumber: | 5859222908 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2014 | ||||||||
| LastUpdateDate: | 10/25/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | OS14220 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 296152 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 036144183 | IL | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 296152 | NY | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 214881 | 01 | IL | MEDICSARE GROUP PTAN | OTHER |