Provider Demographics
NPI:1487715835
Name:KHAN, SABIR (RPH)
Entity type:Individual
Prefix:MR
First Name:SABIR
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 GEDDES STREET EXT
Mailing Address - Street 2:
Mailing Address - City:HOLLEY
Mailing Address - State:NY
Mailing Address - Zip Code:14470-1122
Mailing Address - Country:US
Mailing Address - Phone:585-638-5499
Mailing Address - Fax:585-638-6149
Practice Address - Street 1:3 GEDDES STREET EXT
Practice Address - Street 2:
Practice Address - City:HOLLEY
Practice Address - State:NY
Practice Address - Zip Code:14470-1122
Practice Address - Country:US
Practice Address - Phone:585-638-5499
Practice Address - Fax:585-638-6149
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist