Individual
AMNA KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
615 VALLEY RD, MONTCLAIR, NJ 07043-1403
(973) 378-0214
Mailing address
15 HIGHVIEW RD, JERSEY CITY, NJ 07305-2105
(201) 240-2676
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y10400
MEDICARE PAN
MA
Enumeration date
06/22/2015
Last updated
08/26/2019
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