Provider Demographics
NPI:1013385186
Name:KHALFAN, MUHAIMINA (PA-C)
Entity Type:Individual
Prefix:
First Name:MUHAIMINA
Middle Name:
Last Name:KHALFAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LORETTA LN
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3716
Mailing Address - Country:US
Mailing Address - Phone:212-912-3455
Mailing Address - Fax:
Practice Address - Street 1:12 LORETTA LN
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3716
Practice Address - Country:US
Practice Address - Phone:212-912-3455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant