Provider Demographics
NPI:1376798454
Name:KHOKHER, SAIRAH (MD)
Entity Type:Individual
Prefix:DR
First Name:SAIRAH
Middle Name:
Last Name:KHOKHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 KYLE WAY
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-2516
Mailing Address - Country:US
Mailing Address - Phone:609-323-7836
Mailing Address - Fax:
Practice Address - Street 1:19 KYLE WAY
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-2516
Practice Address - Country:US
Practice Address - Phone:609-323-7836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08974200207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0279838Medicaid
NJ232509BDKMedicare PIN