Provider Demographics
NPI:1285251108
Name:KHATRI MEDICAL SUITES PC
Entity type:Organization
Organization Name:KHATRI MEDICAL SUITES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KHATRI
Authorized Official - Middle Name:
Authorized Official - Last Name:SARITA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-877-6796
Mailing Address - Street 1:466 WILLIS AVENUE
Mailing Address - Street 2:SUITE 366
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:466 WILLIS AVENUE
Practice Address - Street 2:SUITE 366
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596
Practice Address - Country:US
Practice Address - Phone:718-877-6796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY251223OtherLICENSE