Doctor Name: | DUANE GLEN KHAN |
NPI Number: | 1063762573 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S. |
License Number: | |
Business Practice Address: | 55 Mohawk St Cohoes, NY - 120472600 |
Business Phone Number: | 5182351100 |
Business Fax Number: | |
Mailing Address: | 55b Weis Rd, ALBANY |
State: | NY |
Postal Code: | 122081952 |
Phone Number: | 9549376267 |
Fax Number: | |
NPI Enumeration Date: | 09/12/2012 |
NPI Last Update Date: | 09/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |