Individual
DILRUBA KHANAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1809 JOHN F. KENNEDY BLVD., GROUND FLOOR, JERSEY CITY, NJ 07305
(201) 763-6664
(201) 763-6840
Mailing address
1809 JOHN F. KENNEDY BLVD., GROUND FLOOR, JERSEY CITY, NJ 07305
(201) 763-6664
(201) 763-6840
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA07937600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0123315
—
NJ
Enumeration date
11/29/2006
Last updated
02/01/2011
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