Individual
MAHRUKH ALI KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 SECOND AVENUE, LONG BRANCH, NJ 07740-6303
(315) 335-6447
Mailing address
7280 LAKE VIEW DR, AVA, NY 13303-1807
(315) 335-6447
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/22/2021
Last updated
04/22/2021
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