Individual
KHEMRAJ MOHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
10613 227TH ST, QUEENS VILLAGE, NY 11429-2464
(516) 668-6154
Mailing address
900 FRANKLIN AVE, VALLEY STREAM, NY 11580-2145
(516) 256-6000
(516) 256-6268
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F307100-1
NY
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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