Provider Demographics
NPI:1922392919
Name:KHOKHAR, MAMOONA (MD)
Entity Type:Individual
Prefix:
First Name:MAMOONA
Middle Name:
Last Name:KHOKHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:161 FORT WASHINGTON AVE
Mailing Address - Street 2:HERBERT IRVING PAVILLION, FLOOR 8, ROOM 819
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3729
Mailing Address - Country:US
Mailing Address - Phone:212-305-0444
Mailing Address - Fax:212-305-0445
Practice Address - Street 1:161 FORT WASHINGTON AVE
Practice Address - Street 2:HERBERT IRVING PAVILLION, FLOOR 8, ROOM 819
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3729
Practice Address - Country:US
Practice Address - Phone:212-305-0444
Practice Address - Fax:212-305-0445
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RILP02343208600000X
NY284600208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery