Provider Demographics
NPI:1134412554
Name:KHALIQ, MEENAH HABAAB (DPT)
Entity type:Individual
Prefix:
First Name:MEENAH
Middle Name:HABAAB
Last Name:KHALIQ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2152
Mailing Address - Country:US
Mailing Address - Phone:240-821-9868
Mailing Address - Fax:301-579-5892
Practice Address - Street 1:9101 2ND AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2152
Practice Address - Country:US
Practice Address - Phone:240-821-9868
Practice Address - Fax:301-579-5892
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23276225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist