Provider Demographics
NPI:1972818094
Name:KHANNA, SWEENY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SWEENY
Middle Name:
Last Name:KHANNA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 GALLERIA DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-6343
Mailing Address - Country:US
Mailing Address - Phone:856-262-3052
Mailing Address - Fax:
Practice Address - Street 1:1360 BLACKWOOD CLEMENTON RD.
Practice Address - Street 2:
Practice Address - City:CLEMENTON
Practice Address - State:NJ
Practice Address - Zip Code:08021
Practice Address - Country:US
Practice Address - Phone:856-627-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437916183500000X
NJ28RI03110600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist