Individual provider Active NPI

Nahid Khan

  • Internal Medicine Physician
  • Farmingdale, NY
National Provider Identifier
1811768658
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P126519 Issued in NY
Practice address
100 Broadhollow Rd Ste 106
Farmingdale, NY 11735-4813
Phone
(631) 693-6644
NPI assigned
Jan 10, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X P126519 NY Primary

Addresses

Primary practice location

100 Broadhollow Rd Ste 106
Farmingdale, NY 11735-4813

Mailing address

1330 Waring Ave
Bronx, NY 10469-5741
Phone (718) 687-6261

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

LicenseStateTypeSpecialty
P126519NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cordial Medical, P.C. Multi-Specialty CurrentSince Jan 14, 2024 Accepting new patients

Locations

100 Broadhollow Rd
Ste 106
Farmingdale, NY 11735
Phone (631) 693-6644

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1811768658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 WARING AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695741",
            "telephone_number": "718-687-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BROADHOLLOW RD STE 106",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354813",
            "telephone_number": "631-693-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "NAHID",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-10",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P126519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.