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General NPI Number Information
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NPI Number | 1972168367
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Entity Type | Individual
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Provider Name | PUSHPA KHANAL M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/01/2019
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 1425 PORTLAND AVE
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City | ROCHESTER
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State | NY
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Zip | 14621-3011
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Country | US
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Telephone | 585-922-5027
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Fax |
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Provider Business Mailing Address
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Address Line | ONE GUTHRIE SQUARE, INTERNAL MEDICINE RESIDENCY GUTHRIE
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City | SAYRE
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State | PA
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Zip | 18840
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Country | US
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Telephone | 971-706-8630
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 319203
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 319203
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License Number State | NY
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