Organization
MIRA KHENY MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRA KHENY (PHYSICIAN/OWNER)
(856) 910-8100
Entity
Organization
Contact information
Practice address
6650 BROWNING RD, SUITE M21, PENNSAUKEN, NJ 08109-1479
(856) 910-8100
(856) 910-8101
Mailing address
PO BOX 1077, VOORHEES, NJ 08043-7077
(856) 910-8100
(856) 910-8101
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA04506900
NJ
Other
Enumeration date
12/09/2010
Last updated
12/10/2010
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