Provider Demographics
NPI:1447059985
Name:KHAN, SAEFULLAH
Entity type:Individual
Prefix:
First Name:SAEFULLAH
Middle Name:
Last Name:KHAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8611 151ST AVE APT 4K
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-1329
Mailing Address - Country:US
Mailing Address - Phone:347-251-3587
Mailing Address - Fax:
Practice Address - Street 1:8611 151ST AVE APT 4K
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-1329
Practice Address - Country:US
Practice Address - Phone:347-251-3587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies