Provider Demographics
NPI:1639818834
Name:KHANNA, RUPINA (DC)
Entity Type:Individual
Prefix:
First Name:RUPINA
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 1:328 CRITTENDEN WAY APT 1
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-2211
Mailing Address - Country:US
Mailing Address - Phone:510-646-5621
Mailing Address - Fax:
Practice Address - Street 1:1174 MOUNT HOPE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2911
Practice Address - Country:US
Practice Address - Phone:585-445-8584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX013585-01111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor