Provider Demographics
NPI:1982927513
Name:KHAN, RAFSA Y
Entity Type:Individual
Prefix:MISS
First Name:RAFSA
Middle Name:Y
Last Name:KHAN
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 1:4140 UNION ST APT 7Y
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2510
Mailing Address - Country:US
Mailing Address - Phone:917-853-9900
Mailing Address - Fax:
Practice Address - Street 1:4140 UNION ST APT 7Y
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2510
Practice Address - Country:US
Practice Address - Phone:917-853-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054063183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist