Khanna Pediatrics, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MB08137900 Issued in NJ

Legal business name

KHANNA PEDIATRICS, LLC

Practice address

401 Ridgewood Ave
Glen Ridge, NJ 07028-1512

Phone

(973) 748-6470

Fax

(973) 748-1834

NPI assigned

Jan 23, 2009

Last updated

Jan 23, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anisha Khanna, D.O.NPI 1912110826

Title

Physician

Phone

(973) 748-6470

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anisha Khanna, D.O.

  • Pediatrics Physician
  • Glen Ridge, NJ
  • NPI 1912110826
  NPD (past) Authorized official
• Kamlesh Khanna, MD

  • Pediatrics Physician
  • Glen Ridge, NJ
  • NPI 1487782579
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232668800000",
    "number": "1275771503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 RIDGEWOOD AVE",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281512",
            "telephone_number": "973-748-6470",
            "fax_number": "973-748-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 RIDGEWOOD AVE",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281512",
            "telephone_number": "973-748-6470",
            "fax_number": "973-748-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHANNA PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-23",
        "last_updated": "2009-01-23",
        "status": "A",
        "authorized_official_last_name": "KHANNA",
        "authorized_official_first_name": "ANISHA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "973-748-6470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MB08137900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0182796",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathrine Berdebes Kent, MS RD
• Mikhail I. Khaimov, D.O.
• Khaula Khalid, DO
• Mazin Khalid, MD
• Khanna Nephrology, L.L.C.
• Anisha Khanna, D.O.
• Kamlesh Khanna, MD
• Martine Kieffer, LCSW
• Samuel Kim, MD
• Sung T. Kim, M.D.

• Pediatrics Physician in Glen Ridge, NJ
• Providers in Glen Ridge, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.