Provider Demographics
NPI:1831080589
Name:KHAN, ANIKA NURIN (PHD)
Entity type:Individual
Prefix:
First Name:ANIKA
Middle Name:NURIN
Last Name:KHAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 MONTROSE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1933
Mailing Address - Country:US
Mailing Address - Phone:919-889-0002
Mailing Address - Fax:
Practice Address - Street 1:201 N PRESIDENTIAL BLVD STE 102
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1257
Practice Address - Country:US
Practice Address - Phone:919-889-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020410103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical