SOUTHERN TIER PEDIATRICS PRACTICE, P.C.
Medical Practice at Foote Avenue Ext, Jamestown, NY

License number
New York 207469
Category
Medical Practice
Type
Adolescent Medicine
Owner
Name: TARIQ M KHAN M.D.
Title: PRESIDENT
Phone: (716) 661-9730
Address
Address
1684 Foote Avenue Ext, Jamestown, NY 14701
National Provider ID: 1710902200
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SOUTHERN TIER PEDIATRICS PRACTICE, PC

1684 Foote Ave Ext, Jamestown, NY 14701

Doing business as:
TARIQ M. KHAN, PHYSICIAN, PC
Registration:
Jun 30, 1999
State ID:
2393815
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Tariq M. Khan, 1684 Foote Ave Ext, Jamestown, NY 14701 (Physical)

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