Individual
ISHRA KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
(631) 385-7780
Mailing address
8324 168TH PL, JAMAICA, NY 11432-1913
(929) 218-3955
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/09/2022
Last updated
11/09/2022
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