Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0700X | Prosthodontist | 053649 | NY |
Y | 1223P0700X | Prosthodontist | 22DI02350900 | NJ |
NPI | 1205049707 |
---|---|
Provider Name | Dr. Yatin Khanna |
First Address | Jersey City, NJ 07310-2001 |
Second Address | Brooklyn, NY 11215-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 05/01/2017 |