Provider Demographics
NPI:1770558843
Name:KHAKOO, RAFIYA S (MD)
Entity type:Individual
Prefix:DR
First Name:RAFIYA
Middle Name:S
Last Name:KHAKOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:154 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-2048
Mailing Address - Country:US
Mailing Address - Phone:732-616-4751
Mailing Address - Fax:732-332-1339
Practice Address - Street 1:721 N BEERS ST
Practice Address - Street 2:SUITE 2H
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1518
Practice Address - Country:US
Practice Address - Phone:732-616-4751
Practice Address - Fax:732-332-1339
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA065807002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
130022634OtherRAILROAD MEDICARE
1954801OtherUNITED HEALTHCARE
P2076457OtherOXFORD HEALTH PLAN
NJ7501200Medicaid
NJ011199Medicare PIN
1954801OtherUNITED HEALTHCARE
P2076457OtherOXFORD HEALTH PLAN