Healthcare Provider Details

I. General information

NPI: 1316396773
Provider Name (Legal Business Name): KHURRAM SALEEM JANJUA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 01/04/2022
Certification Date: 01/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 WELLNESS WAY
READING PA
19605-8902
US

IV. Provider business mailing address

201 WELLNESS WAY
READING PA
19605-8902
US

V. Phone/Fax

Practice location:
  • Phone: 484-659-2300
  • Fax: 610-374-1619
Mailing address:
  • Phone: 484-659-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD473662
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: