Provider Demographics
NPI:1942562475
Name:KHAN, KENDRA ZABRINA (BA)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:ZABRINA
Last Name:KHAN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 5TH AVE
Mailing Address - Street 2:NORTHSIDE CENTER FOR CHILD DEVELOPMENT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3119
Mailing Address - Country:US
Mailing Address - Phone:212-426-3458
Mailing Address - Fax:917-484-4433
Practice Address - Street 1:1301 5TH AVE
Practice Address - Street 2:NORTHSIDE CENTER FOR CHILD DEVELOPMENT
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3119
Practice Address - Country:US
Practice Address - Phone:212-426-3458
Practice Address - Fax:917-484-4433
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator