| Doctor Name: | DR. MANSOOR A KHAN |
| NPI Number: | 1104081900 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 265529 |
| Business Practice Address: | 9217 101st Ave Ozone Park, NY - 114162316 |
| Business Phone Number: | 4124524262 |
| Business Fax Number: | |
| Mailing Address: | 9217 101st Ave, OZONE PARK |
| State: | NY |
| Postal Code: | 114162316 |
| Phone Number: | 4124524262 |
| Fax Number: | |
| NPI Enumeration Date: | 07/22/2008 |
| NPI Last Update Date: | 04/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 265529 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |