Provider Demographics
NPI:1922547553
Name:KHUSHNOOD, SHANZA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHANZA
Middle Name:
Last Name:KHUSHNOOD
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 1:3637 193RD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-2459
Mailing Address - Country:US
Mailing Address - Phone:347-659-0305
Mailing Address - Fax:
Practice Address - Street 1:3637 193RD ST APT 2
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-2459
Practice Address - Country:US
Practice Address - Phone:347-659-0305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist