Provider Demographics
NPI:1629461579
Name:KHAN, SHAMA (MPH, MS)
Entity Type:Individual
Prefix:
First Name:SHAMA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:MPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 PATERSON ST
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1962
Mailing Address - Country:US
Mailing Address - Phone:732-235-6630
Mailing Address - Fax:732-235-5230
Practice Address - Street 1:125 PATERSON ST
Practice Address - Street 2:SUITE 2100
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1962
Practice Address - Country:US
Practice Address - Phone:732-235-6630
Practice Address - Fax:732-235-5230
Is Sole Proprietor?:No
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS