person
Pervez Ali Khan, MD
General Practice Physician in Lackawanna, New York
NPI 1780857854

Pervez Ali Khan is a General Practice Physician based in Lackawanna, NY. Pervez Ali Khan practices in Lackawanna, NY and has the professional credentials of MD. The NPI Number for Pervez Ali Khan is 1780857854 and holds a License No. 125843 (New York).

The current practice location address for Pervez Ali Khan is 2600 Southpark Avenue, Lackawanna, NY and can be reached out via phone at 716-822-2028 and via fax at 716-822-2029.

Location: 2600 Southpark Avenue, Lackawanna, NY, 14218-1504
person
Provider Profile Details
NPI Number
1780857854
Provider Name
Pervez Ali Khan
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
2600 Southpark Avenue, Lackawanna, NY, 14218-1504
Phone Number
716-822-2028
Fax Number
716-822-2029
Provider Enumeration Date
04/09/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2197231 01 NY COVENTRY
4538333 01 NY AETNA
RB8099 01 NY MEDICARE RAILROAD
02961200 05 NY
institution
Provider Business Practice Location Address Details
Address
2600 Southpark Avenue
City
State
Zip
14218-1504
Phone Number
716-822-2028
Fax Number
716-822-2029
person
Provider Business Mailing Address Details
Address
2600 Southpark Avenue
City
State
Zip
14218-1504
Phone Number
716-822-2028
Fax Number
716-822-2029
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
125843 (New York)
Definition
Definition to come...
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