National Provider Identifier
Pervez Ali Khan, M.D.
Pervez Ali Khan, M.D. is listed in the NPPES registry with a primary specialty of General Practice Physician in Lackawanna, NY and a listed phone number of (716) 822-2028.
Profile Overview
- NPI
- 1780857854
- Provider Type
- Individual
- Primary Specialty
- General Practice Physician
- Enumeration Date
- April 09, 2008
- Last Updated
- April 05, 2017
Practice Location
- 2600 Southpark Avenue
- Lackawanna, NY 14218-1504
Phone: (716) 822-2028
Specialties
- General Practice Physician (208D00000X)
Full Record
- NPI
- 1780857854
- Entity Type
- Individual
- Last Name
- Khan
- First Name
- Pervez
- Middle Name
- Ali
- Credential
- M.D.
- Mailing Street Address
- 2600 Southpark Avenue
- Mailing City
- Lackawanna
- Mailing State
- NY
- Mailing ZIP Code
- 14218-1504
- Mailing Country
- US
- Mailing Phone
- (716) 822-2028
- Mailing Fax
- (716) 822-2029
- Practice Street Address
- 2600 Southpark Avenue
- Practice City
- Lackawanna
- Practice State
- NY
- Practice ZIP Code
- 14218-1504
- Practice Country
- US
- Practice Phone
- (716) 822-2028
- Practice Fax
- (716) 822-2029
- Enumeration Date
- April 09, 2008
- Last Updated
- April 05, 2017
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- General Practice Physician (208D00000X)
- Other Identifiers
- 2197231 (NY, Coventry), 4538333 (NY, Aetna), RB8099 (NY, Medicare Railroad), 02961200 (NY)