Provider Demographics
NPI:1811526973
Name:KHETAN, PRERNA (MD)
Entity type:Individual
Prefix:DR
First Name:PRERNA
Middle Name:
Last Name:KHETAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:STONY BROOK UNIVERSITY HOSPITAL, NICHOLS ROAD
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY, LEVEL 2- 749
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-7025
Mailing Address - Country:US
Mailing Address - Phone:631-444-2222
Mailing Address - Fax:631-444-3419
Practice Address - Street 1:STONY BROOK UNIVERSITY HOSPITAL, NICHOLS ROAD
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY, LEVEL 2- 749
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-7025
Practice Address - Country:US
Practice Address - Phone:631-444-2222
Practice Address - Fax:631-444-3419
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2020-04-03
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program