Provider Demographics
NPI:1437167509
Name:NANDITA M. KHANEJA, MD, P.C.
Entity Type:Organization
Organization Name:NANDITA M. KHANEJA, MD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANDITA
Authorized Official - Middle Name:MATHUR
Authorized Official - Last Name:KHANEJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-263-0709
Mailing Address - Street 1:7007 PARK DR E
Mailing Address - Street 2:#1L
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1951
Mailing Address - Country:US
Mailing Address - Phone:718-263-0709
Mailing Address - Fax:718-263-9666
Practice Address - Street 1:1200 GRAVESEND NECK RD
Practice Address - Street 2:#1A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4256
Practice Address - Country:US
Practice Address - Phone:718-332-3555
Practice Address - Fax:718-263-9666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236763207K00000X, 208000000X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Not Answered2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1629005947OtherPERSONAL NPI