Individual
ANITA KHAWAJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
687 FRELINGHUYSEN AVE, NEWARK, NJ 07114-1334
(973) 799-0508
Mailing address
687 FRELINGHUYSEN AVE, NEWARK, NJ 07114-1349
(973) 799-0508
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
2000172
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0062821
—
NJ
05
—
7466200
—
NJ
Enumeration date
11/07/2013
Last updated
11/07/2013
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