Provider Demographics
NPI:1356396097
Name:KHWAJA, RAHILA
Entity type:Individual
Prefix:
First Name:RAHILA
Middle Name:
Last Name:KHWAJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 LINCOLN WAY
Mailing Address - Street 2:SUITE 290
Mailing Address - City:WHITE OAK
Mailing Address - State:PA
Mailing Address - Zip Code:15131-2419
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2001 LINCOLN WAY
Practice Address - Street 2:SUITE 290
Practice Address - City:WHITE OAK
Practice Address - State:PA
Practice Address - Zip Code:15131-2419
Practice Address - Country:US
Practice Address - Phone:412-673-0214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044663L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012535830007Medicaid
PAE96593Medicare UPIN
PA0012535830007Medicaid