Healthcare Provider Details

I. General information

NPI: 1477795359
Provider Name (Legal Business Name): MUNIYA SHREYASHI KHANNA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2009
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 WHITE HORSE RD
BERWYN PA
19312-1525
US

IV. Provider business mailing address

2600 WHITE HORSE RD
BERWYN PA
19312-1525
US

V. Phone/Fax

Practice location:
  • Phone: 610-202-9274
  • Fax:
Mailing address:
  • Phone: 610-202-9274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS016563
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: