Healthcare Provider Details

I. General information

NPI: 1508950684
Provider Name (Legal Business Name): MADHURANI KHARE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 HERRONTOWN RD PRINCETON HOUSE BEHAVIORAL HEALTH
PRINCETON NJ
08540-1901
US

IV. Provider business mailing address

300 CLOCKTOWER DR STE 101
HAMILTON NJ
08690-3010
US

V. Phone/Fax

Practice location:
  • Phone: 609-497-3300
  • Fax: 609-497-3370
Mailing address:
  • Phone: 609-688-2774
  • Fax: 609-683-3291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA06748200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: