Basic Information
| Provider Information | |||||||||
| NPI: | 1609283399 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHAN | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | YASMINE | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | M.A. SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21 WESTGATE RD | ||||||||
| Address2: | |||||||||
| City: | MASSAPEQUA PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117621950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167211661 | ||||||||
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| Practice Location | |||||||||
| Address1: | 200 SKILES BLVD | ||||||||
| Address2: | |||||||||
| City: | WEST CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193827321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8005787906 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2014 | ||||||||
| LastUpdateDate: | 07/15/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 040000395 | DE | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.