Provider Demographics
NPI:1477259935
Name:KHAN, MEHERUNISA (BCBA)
Entity Type:Individual
Prefix:
First Name:MEHERUNISA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 S BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3230
Mailing Address - Country:US
Mailing Address - Phone:908-612-9161
Mailing Address - Fax:
Practice Address - Street 1:316 W WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:ROSELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07204-1841
Practice Address - Country:US
Practice Address - Phone:888-966-0746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst