Active NPI
Maxine Khan
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1366747958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 030428
- Practice address
- 111 Livingston St
Suite 1101
Brooklyn, NY 11201-1260 - Phone
- (646) 662-2562
- NPI assigned
- Jan 13, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 030428 | NY | Primary |
Addresses
Primary practice location
111 Livingston St
Suite 1101
Brooklyn, NY 11201-1260
Mailing address
65 Court St
Brooklyn, NY 11201-4916
Phone (347) 433-5033
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030428 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675814400000",
"number": "1366747958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 COURT ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112014916",
"telephone_number": "347-433-5033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 LIVINGSTON ST",
"address_2": "SUITE 1101",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112011260",
"telephone_number": "646-662-2562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "MAXINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-13",
"last_updated": "2023-02-08",
"certification_date": "2023-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "030428",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.