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NPI Code Detail

MEDICARE: ABBAS KHAN

MEDICARE: ABBAS KHAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor19509CA
2101YM0800XMental Health CounselorCMH0208951NM

General Provider Information

NPI Number : 1497395396
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABBAS KHAN
Provider Business Mailing Address
First Line : PO BOX 1595
Second Line :
City : MIDDLETOWN
State : CT
Zip : 06457-8095
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 206 S CORONADO AVE
Second Line :
City : ESPANOLA
State : NM
Zip : 87532-2792
Country : US
Telephone Number : 860-788-6404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2020
Last Update Date : 01/06/2026

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Directions to “ ABBAS KHAN ” Practice Location

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