Healthcare Provider Details

I. General information

NPI: 1497215206
Provider Name (Legal Business Name): RACHNA KHANNA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 03/31/2024
Certification Date: 03/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 NEW SCOTLAND AVE
ALBANY NY
12208-3412
US

IV. Provider business mailing address

47 NEW SCOTLAND AVENUE, DEPT. OF NEUROLOGY
ALBANY NY
12208
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-5735
  • Fax:
Mailing address:
  • Phone: 518-262-3095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number64182
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number80033401308
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: