| South Asian Ipa, Llc | |
|
530 Conduit Blvd Suite - C Brooklyn NY 11208-3245 | |
| (718) 277-5500 | |
| (718) 277-2400 |
| Full Name | South Asian Ipa, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 530 Conduit Blvd, Brooklyn, New York |
| Authorized Official Name and Position | Zaber Ahmad Khan (PRESIDENT) |
| Authorized Official Contact | 6467527058 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Asian Ipa, Llc 530 Conduit Blvd Suite - C Brooklyn NY 11208-3245 Ph: (718) 277-5500 | South Asian Ipa, Llc 530 Conduit Blvd Suite - C Brooklyn NY 11208-3245 Ph: (718) 277-5500 |
| NPI Number | 1164957783 |
|---|---|
| Provider Enumeration Date | 04/21/2017 |
| Last Update Date | 04/21/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164957783 | NPI | - | NPPES |
| 02807454 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 234133 (New York) | Primary |
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