Provider Demographics
NPI:1871925156
Name:KHANNA, PRIYANKA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PRIYANKA
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 1:2235 SPRINGFIELD AVE
Mailing Address - Street 2:2141
Mailing Address - City:VAUXHALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07088-1100
Mailing Address - Country:US
Mailing Address - Phone:908-622-9003
Mailing Address - Fax:
Practice Address - Street 1:2235 SPRINGFIELD AVE
Practice Address - Street 2:2141
Practice Address - City:VAUXHALL
Practice Address - State:NJ
Practice Address - Zip Code:07088-1100
Practice Address - Country:US
Practice Address - Phone:908-622-9003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03505700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist