Mira Kheny MD LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA04506900 Issued in NJ

Legal business name

MIRA KHENY MD LLC

Practice address

6650 Browning Rd
Suite M21
Pennsauken, NJ 08109-1479

Phone

(856) 910-8100

Fax

(856) 910-8101

NPI assigned

Dec 9, 2010

Organization subpart

No

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

Authorized official

Name

Mira Kheny

Title

Physician/Owner

Phone

(856) 910-8100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291939200000",
    "number": "1598068744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1077",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080437077",
            "telephone_number": "856-910-8100",
            "fax_number": "856-910-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 BROWNING RD",
            "address_2": "SUITE M21",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081091479",
            "telephone_number": "856-910-8100",
            "fax_number": "856-910-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRA KHENY MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-09",
        "last_updated": "2010-12-10",
        "status": "A",
        "authorized_official_last_name": "KHENY",
        "authorized_official_first_name": "MIRA",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "856-910-8100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA04506900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Mercado, RN
• Mi Familia Practice
• Michelle E Liggio
• Jeri Middlebrook, MSW, CSW
• Susan M Midili, APN
• Eric Misthal, EMT
• Natalie Mitchem, R.D.
• Tamikia Mobley, CRT
• Matthew Paul Moles Jr.
• Gabriel Montanez

• Family Medicine Physician in Pennsauken, NJ
• Providers in Pennsauken, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2010; 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.