Healthcare Provider Details

I. General information

NPI: 1770190159
Provider Name (Legal Business Name): ANAMIKA KHARB PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2414 15TH ST
TROY NY
12180-1701
US

IV. Provider business mailing address

2414 15TH ST
TROY NY
12180-1701
US

V. Phone/Fax

Practice location:
  • Phone: 518-271-1813
  • Fax: 518-271-1931
Mailing address:
  • Phone: 518-271-1813
  • Fax: 518-271-1931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number028256
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: