Provider Demographics
NPI:1376785527
Name:KHWAJA, AFSHAN (MLSW)
Entity Type:Individual
Prefix:
First Name:AFSHAN
Middle Name:
Last Name:KHWAJA
Suffix:
Gender:F
Credentials:MLSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 LARCH DR
Mailing Address - Street 2:
Mailing Address - City:MANHASSET HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2329
Mailing Address - Country:US
Mailing Address - Phone:516-610-8676
Mailing Address - Fax:
Practice Address - Street 1:105 LARCH DR
Practice Address - Street 2:
Practice Address - City:MANHASSET HILLS
Practice Address - State:NY
Practice Address - Zip Code:11040-2329
Practice Address - Country:US
Practice Address - Phone:516-610-8676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-02
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY204220959OtherTAX ID