Healthcare Provider Details

I. General information

NPI: 1689688319
Provider Name (Legal Business Name): NEIL KHILNANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 04/12/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST BOX 141
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

525 E 68TH ST BOX 141
NEW YORK NY
10065-4870
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-2059
  • Fax:
Mailing address:
  • Phone: 212-746-2059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number174604
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: