Provider Demographics
NPI:1831319649
Name:KHANI, NADIA (MD)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:KHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NADIA
Other - Middle Name:
Other - Last Name:DALATI-KHANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:24 WOODMERE DR
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-2210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 HEALTH PLZ
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-1016
Practice Address - Country:US
Practice Address - Phone:862-778-7961
Practice Address - Fax:973-781-6504
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA346132083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine