Provider Demographics
NPI:1760406235
Name:KHATRI, ANU (DO)
Entity Type:Individual
Prefix:DR
First Name:ANU
Middle Name:
Last Name:KHATRI
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 1:3070 BRISTOL PIKE
Mailing Address - Street 2:STE 124
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-5364
Mailing Address - Country:US
Mailing Address - Phone:215-245-0272
Mailing Address - Fax:215-244-1005
Practice Address - Street 1:3070 BRISTOL PIKE
Practice Address - Street 2:STE 124
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-5364
Practice Address - Country:US
Practice Address - Phone:215-245-0272
Practice Address - Fax:215-244-1005
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008836L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG51754Medicare UPIN
PA951518Medicare ID - Type UnspecifiedMCR