MEDICARE: DR. HEMANSHU BATISH KHANNA O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	TUV007280-1	NY

General Provider Information

NPI Number	:	1407012024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEMANSHU BATISH KHANNA O.D.

Provider Business Mailing Address
First Line	:	173 MOUNT JOY PL
Second Line	:
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10801-1602
Country	:	US
Telephone Number	:	914-239-3171
Fax Number	:

Provider Business Practice Location Address
First Line	:	173 MOUNT JOY PL
Second Line	:
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10801-1602
Country	:	US
Telephone Number	:	914-239-3171
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2008
Last Update Date	:	08/03/2008

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