Provider Demographics
NPI:1710453162
Name:KHAN, SABA (PSYD)
Entity Type:Individual
Prefix:
First Name:SABA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 W END AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1816
Mailing Address - Country:US
Mailing Address - Phone:908-333-4646
Mailing Address - Fax:
Practice Address - Street 1:134 W END AVE FL 1
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1816
Practice Address - Country:US
Practice Address - Phone:908-333-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ183-079103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist