Provider Demographics
NPI:1467431106
Name:KHANEJA, MUNISH (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MUNISH
Middle Name:
Last Name:KHANEJA
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 670992
Mailing Address - Street 2:75-23 MAIN STREET
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-0992
Mailing Address - Country:US
Mailing Address - Phone:718-263-0709
Mailing Address - Fax:718-263-9666
Practice Address - Street 1:11120 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6341
Practice Address - Country:US
Practice Address - Phone:718-263-2208
Practice Address - Fax:718-263-3442
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222120207R00000X, 208000000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02199562Medicaid
NY02199562Medicaid
275611Medicare ID - Type Unspecified