Provider Demographics
NPI:1588869374
Name:KHILLAN, RATESH (MD)
Entity type:Individual
Prefix:DR
First Name:RATESH
Middle Name:
Last Name:KHILLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 BACON RD
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-1304
Mailing Address - Country:US
Mailing Address - Phone:718-221-9999
Mailing Address - Fax:
Practice Address - Street 1:672 UTICA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2210
Practice Address - Country:US
Practice Address - Phone:718-221-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003427282N00000X
NY266181207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No282N00000XHospitalsGeneral Acute Care Hospital