MEDICARE: DR. ERVA 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
1	2084P0804X	Child & Adolescent Psychiatry Physician	319466	NY
2	2084P0800X	Psychiatry Physician	319466	NY

General Provider Information

NPI Number	:	1790312106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERVA KHAN

Provider Business Mailing Address
First Line	:	317 E 17TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-3804
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 W 136TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10037-2104
Country	:	US
Telephone Number	:	212-939-3370
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	08/28/2025

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Directions to “ DR. ERVA KHAN ” Practice Location

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