Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 25MA07069400 | NJ |
N | 111NI0900X | Internist | 25MA07069400 | NJ |
Y | 207RC0000X | Internist - Cardiovascular Disease | 25MA07069400 | NJ |
N | 207RC0000X | Internist - Cardiovascular Disease | MA70694 | NJ |
N | 207RI0011X | Interventional Cardiology | 25MA07069400 | NJ |
NPI | 1104909712 |
---|---|
Provider Name | Dr. Anirudh Khanna |
First Address | Hackettstown, NJ 07840-2413 |
Second Address | Hackettstown, NJ 07840-2413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 07/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
25MA07069400 | STATE LIC NUMBER (01) | NJ |
8302405 | (05) | NJ |
H16348 | (02) |