Individual
DR. MANOJ KHANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
161 WOODBRIDGE CENTER DRIVE, CLVC, WOODBRIDE, NJ 07095-9998
(215) 450-4239
(973) 588-3941
Mailing address
5 CHESTNUT RD, CEDAR KNOLLS, NJ 07927-1400
(215) 450-4239
(973) 588-3941
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0EG001493
PA
152W00000X
Optometrist
Primary
27OA00611000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245244656
AETNA
NJ
01
—
60588
SPECTERA
NJ
01
—
KH1642005
HIGHMARK BLUE SHIELD
PA
01
—
PA00519
VBA
PA
01
—
PA1493
EYEMED
NJ
Enumeration date
07/28/2006
Last updated
11/19/2011
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