Provider Demographics
NPI:1366807091
Name:NANDITA M. KHANEJA, MD, PC
Entity type:Organization
Organization Name:NANDITA M. KHANEJA, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANDITA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MATHUR KHANEJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-812-4753
Mailing Address - Street 1:PO BOX 670992
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-0992
Mailing Address - Country:US
Mailing Address - Phone:917-674-5108
Mailing Address - Fax:718-812-4753
Practice Address - Street 1:26003 UNION TPKE # A
Practice Address - Street 2:
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-1345
Practice Address - Country:US
Practice Address - Phone:917-674-5108
Practice Address - Fax:718-263-9666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236763207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5N9651Medicare UPIN