Provider Demographics
NPI:1528024627
Name:KHANUJA, AJIT S (MD)
Entity Type:Individual
Prefix:DR
First Name:AJIT
Middle Name:S
Last Name:KHANUJA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1444 MASSACHUSETTS AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-1600
Mailing Address - Country:US
Mailing Address - Phone:518-271-8300
Mailing Address - Fax:518-271-1427
Practice Address - Street 1:1444 MASSACHUSETTS AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-1600
Practice Address - Country:US
Practice Address - Phone:518-271-8300
Practice Address - Fax:518-271-1427
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY111344-1207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00516601Medicaid
NYBA0240Medicare PIN
NYRA2739Medicare ID - Type Unspecified
NYB81549Medicare UPIN