Healthcare Provider Details

I. General information

NPI: 1255488607
Provider Name (Legal Business Name): RAIHANA KHORASANEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 1ST AVE METROPOLITAN HOSPITAL CENTER
NEW YORK NY
10029
US

IV. Provider business mailing address

1641 3RD AVE APT. 10K
NEW YORK NY
10128-3623
US

V. Phone/Fax

Practice location:
  • Phone: 212-423-6645
  • Fax: 212-423-6534
Mailing address:
  • Phone: 212-423-6645
  • Fax: 212-423-6534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number155227
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: