Provider Demographics
NPI:1720847254
Name:HIMANSH KHANNA, MD, PC
Entity Type:Organization
Organization Name:HIMANSH KHANNA, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HIMANSH
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-889-6640
Mailing Address - Street 1:CHURCH ST. STATION
Mailing Address - Street 2:P.O. BOX 13
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10008-0013
Mailing Address - Country:US
Mailing Address - Phone:347-889-6640
Mailing Address - Fax:347-889-6601
Practice Address - Street 1:540 5TH AVE
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5157
Practice Address - Country:US
Practice Address - Phone:347-889-6640
Practice Address - Fax:347-889-6640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty