Provider Demographics
NPI:1710652862
Name:KHAN, AAMINAH P (PHARMD)
Entity Type:Individual
Prefix:
First Name:AAMINAH
Middle Name:P
Last Name:KHAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 S HUNTINGTON AVE APT 12
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4804
Mailing Address - Country:US
Mailing Address - Phone:310-507-3318
Mailing Address - Fax:
Practice Address - Street 1:425 S HUNTINGTON AVE APT 12
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-4804
Practice Address - Country:US
Practice Address - Phone:310-507-3318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH2402591835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist