Provider Demographics
NPI:1003612706
Name:KHANDAKAR, NASHITA (PA-S)
Entity type:Individual
Prefix:
First Name:NASHITA
Middle Name:
Last Name:KHANDAKAR
Suffix:
Gender:
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 VAL VISTA DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-7512
Mailing Address - Country:US
Mailing Address - Phone:609-373-9097
Mailing Address - Fax:
Practice Address - Street 1:5980 RICHMOND HWY APT 718
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22303-2743
Practice Address - Country:US
Practice Address - Phone:609-373-9097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-22
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program