Provider Demographics
NPI:1265424238
Name:KHOSLA, SAVITA (MD)
Entity type:Individual
Prefix:
First Name:SAVITA
Middle Name:
Last Name:KHOSLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1263
Mailing Address - Country:US
Mailing Address - Phone:201-489-2255
Mailing Address - Fax:201-489-4799
Practice Address - Street 1:58 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1263
Practice Address - Country:US
Practice Address - Phone:201-489-2255
Practice Address - Fax:201-489-4799
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04219700207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4219150OtherAETNA PPO
NJ64D771OtherEMPIRE BCBS HACKENSACK
NJBP438OtherOXFORD
NJ047GU1OtherEMPIRE BCBS RIDGEWOOD
NJ64D773OtherEMPIRE BCBS MAHWAH
NJ0298785OtherGHI PPO
NJ4219150OtherAETNA PPO
NJ154003WC0Medicare PIN