Provider Demographics
NPI:1639804412
Name:KHAN, AALIA (OD)
Entity Type:Individual
Prefix:
First Name:AALIA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 VILLAGE RD W
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JCT
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-5212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 QUAKERBRIDGE MALL
Practice Address - Street 2:
Practice Address - City:LAWRENCE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08648
Practice Address - Country:US
Practice Address - Phone:609-897-1036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00713000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist