Healthcare Provider Details

I. General information

NPI: 1982927513
Provider Name (Legal Business Name): MISS RAFSA Y KHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2010
Last Update Date: 03/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4140 UNION ST APT 7Y
FLUSHING NY
11355-2510
US

IV. Provider business mailing address

4140 UNION ST APT 7Y
FLUSHING NY
11355-2510
US

V. Phone/Fax

Practice location:
  • Phone: 917-853-9900
  • Fax:
Mailing address:
  • Phone: 917-853-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number054063
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: