Khokhar, Imtiaz A
Khokhar, Imtiaz A is an individual health care provider with primary practice located at 75 North Country Road , Port Jefferson NY 11777. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Khokhar, Imtiaz A can be contacted via phone (631) 473-1320.Contact Information
Primary practice address
75 North Country Road
Port Jefferson NY 11777
Phone: (631) 473-1320
Fax: (631) 686-7972
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 197453 | New York |
Profile Details
| NPI number | 1629075387 |
|---|---|
| LBN Legal business name | Khokhar, Imtiaz A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2005 |
| Last updated | Feb 6th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629075387 | NPPES |
| New York | MEDICAID | 01720465 |
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