Individual
MR. DEEPAK KHANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
501 S 54TH ST, PHILADELPHIA, PA 19143-1900
(215) 748-9707
(215) 748-9708
Mailing address
5 LIPNICK LN, EDISON, NJ 08820-1955
(732) 343-5242
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS021567
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2018
Last updated
11/22/2022
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