Provider Demographics
NPI:1659819936
Name:KHWAJA, GULNOOR
Entity type:Individual
Prefix:MRS
First Name:GULNOOR
Middle Name:
Last Name:KHWAJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WOODHILL LN
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-2735
Mailing Address - Country:US
Mailing Address - Phone:516-455-2421
Mailing Address - Fax:
Practice Address - Street 1:20 WOODHILL LN
Practice Address - Street 2:
Practice Address - City:GLEN HEAD
Practice Address - State:NY
Practice Address - Zip Code:11545-2735
Practice Address - Country:US
Practice Address - Phone:516-455-2421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist