Provider Demographics
NPI:1720669088
Name:K MEDICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:K MEDICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANISH
Authorized Official - Middle Name:P
Authorized Official - Last Name:KHETANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-612-8485
Mailing Address - Street 1:55-77 SCHANCK RD STE B-13
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2964
Mailing Address - Country:US
Mailing Address - Phone:732-612-8485
Mailing Address - Fax:732-612-8483
Practice Address - Street 1:55-77 SCHANCK RD STE B-13
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2964
Practice Address - Country:US
Practice Address - Phone:732-612-8485
Practice Address - Fax:732-612-8483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty