Individual ProviderMoazzam KhanStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address169 Riverside Dr, Binghamton, NY 13905-4246(607) 798-5111(631) 846-8900PECOS EnrollmentBased on the most recent information from CMS, provider Moazzam Khan does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1710680756Provider TypeIndividualFull NameKhan, MoazzamTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date3/27/2023Last Updated3/27/2023Contact InformationPractice LocationPractice Address169 Riverside Dr, Binghamton, NY 13905-4246Phone(607) 798-5111FaxUnlisted FaxMailing LocationMailing Address15 Willowood Ln, Coram, NY 11727-1130Phone(631) 846-8900FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer