Provider Demographics
NPI:1558050252
Name:KHANNA, DENISE (DC)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:KHANNA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 NIAGARA FALLS BLVD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-1268
Mailing Address - Country:US
Mailing Address - Phone:716-331-3232
Mailing Address - Fax:716-331-3211
Practice Address - Street 1:142 NIAGARA FALLS BLVD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-1268
Practice Address - Country:US
Practice Address - Phone:716-331-3232
Practice Address - Fax:716-331-3211
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013005111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor