Individual
MARYANN KHOUDARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
99 BEAUVOIR AVE, SUMMIT, NJ 07901-3533
(908) 522-2000
Mailing address
PO BOX 41657, BOSTON, MA 02241-6457
(973) 656-6280
(973) 290-7495
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
MA69077
NJ
207VH0002X
Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
MA69077
NJ
Other
Enumeration date
04/07/2007
Last updated
09/24/2013
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