Provider Demographics
NPI:1851068290
Name:KHAN, MIAH (LMSW)
Entity Type:Individual
Prefix:
First Name:MIAH
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 AVENUE OF THE AMERICAS FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-1594
Mailing Address - Country:US
Mailing Address - Phone:631-303-9125
Mailing Address - Fax:
Practice Address - Street 1:121 AVENUE OF THE AMERICAS FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-1594
Practice Address - Country:US
Practice Address - Phone:646-946-9258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker