Provider Demographics
NPI:1508828567
Name:KHOKHAR, RIZWANA TAHIR (MD)
Entity Type:Individual
Prefix:DR
First Name:RIZWANA
Middle Name:TAHIR
Last Name:KHOKHAR
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 1:36 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-2440
Mailing Address - Country:US
Mailing Address - Phone:973-239-7001
Mailing Address - Fax:973-239-8867
Practice Address - Street 1:36 PARK AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2440
Practice Address - Country:US
Practice Address - Phone:973-239-7001
Practice Address - Fax:973-239-8867
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0555332080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine