MEDICARE: VIKRANT KHANDERIA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	229935-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013079011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIKRANT KHANDERIA MD

Provider Business Mailing Address
First Line	:	55 WATER ST FL 2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10041-0010
Country	:	US
Telephone Number	:	646-680-2888
Fax Number	:	516-542-5556

Provider Business Practice Location Address
First Line	:	154 WEST 71ST STREET
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-4005
Country	:	US
Telephone Number	:	212-496-4600
Fax Number	:	917-441-0195

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	01/26/2026

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Directions to “ VIKRANT KHANDERIA MD” Practice Location

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