Provider Demographics
NPI:1689943821
Name:KHALIL, CHRISTINA (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:KHALIL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 DELAWARE DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3256
Mailing Address - Country:US
Mailing Address - Phone:201-978-6527
Mailing Address - Fax:
Practice Address - Street 1:901 US HIGHWAY 202
Practice Address - Street 2:
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1419
Practice Address - Country:US
Practice Address - Phone:908-253-6640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-16
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09535000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine