Individual
AISHA KHIZAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13214 101ST AVE, SOUTH RICHMOND HILL, NY 11419
(917) 930-2095
Mailing address
13214 101ST AVE, SOUTH RICHMOND HILL, NY 11419-2315
(917) 930-2095
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1104340171
NY
Other
Enumeration date
02/17/2017
Last updated
02/17/2017
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