Provider Demographics
NPI:1942463716
Name:KHAN, ALIA KATHERINE (DO)
Entity Type:Individual
Prefix:DR
First Name:ALIA
Middle Name:KATHERINE
Last Name:KHAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 CENTRAL AVE
Mailing Address - Street 2:APT 326
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-1539
Mailing Address - Country:US
Mailing Address - Phone:917-783-9029
Mailing Address - Fax:
Practice Address - Street 1:620 EAST BOSTON POST ROAD
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543
Practice Address - Country:US
Practice Address - Phone:914-777-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249127208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics