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General NPI Number Information
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NPI Number | 1518552041
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Entity Type | Individual
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Provider Name | MAYISHA AHSAN-KHAN OD
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Gender | Female
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Dates
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Enumeration Date | 03/05/2021
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 19861 FOOTHILL AVE
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City | HOLLIS
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State | NY
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Zip | 11423-1611
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Country | US
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Telephone | 647-338-2379
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Fax |
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Provider Business Mailing Address
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Address Line | 63 WINDSOR ROAD
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City | ETOBICOKE
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State | ONTARIO
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Zip | M9R 3G6
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Country | CA
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3222
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618002995
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TPOP57
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3731-35
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 009310
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License Number State | NY
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