Provider Demographics
NPI:1255371712
Name:SINDHU, KHALID P (MD)
Entity type:Individual
Prefix:
First Name:KHALID
Middle Name:P
Last Name:SINDHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19316 US ROUTE 11 STE B
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-6736
Mailing Address - Country:US
Mailing Address - Phone:315-782-0136
Mailing Address - Fax:315-782-7212
Practice Address - Street 1:19316 US ROUTE 11 STE B
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-6736
Practice Address - Country:US
Practice Address - Phone:315-782-0136
Practice Address - Fax:315-782-7212
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY197030207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01881483Medicaid
NY01881483Medicaid
NY51763DMedicare PIN