Provider Demographics
NPI:1184812257
Name:KHAN, AFSHAN M (MD)
Entity type:Individual
Prefix:PROF
First Name:AFSHAN
Middle Name:M
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AFSHAN
Other - Middle Name:
Other - Last Name:KHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1654 MAYFLOWER AVE
Mailing Address - Street 2:BRONX
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4818
Mailing Address - Country:US
Mailing Address - Phone:718-823-7180
Mailing Address - Fax:718-823-0839
Practice Address - Street 1:1654 MAYFLOWER AVE
Practice Address - Street 2:BRONX
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4818
Practice Address - Country:US
Practice Address - Phone:718-823-7180
Practice Address - Fax:718-823-0839
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-13
Last Update Date:2007-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1984622084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY548581Medicare PIN