Provider Demographics
NPI:1629005947
Name:MATHUR KHANEJA, NANDITA M (MD)
Entity Type:Individual
Prefix:DR
First Name:NANDITA
Middle Name:M
Last Name:MATHUR KHANEJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NANDITA
Other - Middle Name:
Other - Last Name:MATHUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 670992
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-0992
Mailing Address - Country:US
Mailing Address - Phone:718-812-4753
Mailing Address - Fax:718-263-9666
Practice Address - Street 1:11207 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-8311
Practice Address - Country:US
Practice Address - Phone:800-381-3462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236763208000000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics