Provider Demographics
NPI:1386222792
Name:KHAN, SAMEER AHMAD (DO)
Entity type:Individual
Prefix:DR
First Name:SAMEER
Middle Name:AHMAD
Last Name:KHAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 CAPRI DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576
Mailing Address - Country:US
Mailing Address - Phone:516-581-0262
Mailing Address - Fax:631-376-3420
Practice Address - Street 1:1825 EASTCHESTER ROAD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-904-2000
Practice Address - Fax:631-376-3420
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program