Provider Demographics
NPI:1568689677
Name:KHAN, JULIANNE MELISSA (PT, DPT)
Entity Type:Individual
Prefix:MISS
First Name:JULIANNE
Middle Name:MELISSA
Last Name:KHAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 W 74TH ST
Mailing Address - Street 2:APT C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2304
Mailing Address - Country:US
Mailing Address - Phone:212-380-1096
Mailing Address - Fax:
Practice Address - Street 1:31 HUDSON YARDS FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2170
Practice Address - Country:US
Practice Address - Phone:646-422-5960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025527-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist