MEDICARE: DR. SATISH C KHANEJA M.D.

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	2086S0129X	Vascular Surgery Physician	121579	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	:	1982698197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SATISH C KHANEJA M.D.

Provider Business Mailing Address
First Line	:	1650 SELWYN AVE
Second Line	:	MILSTEIN 5A
City	:	BRONX
State	:	NY
Zip	:	10457-7626
Country	:	US
Telephone Number	:	718-960-1235
Fax Number	:	718-960-1051

Provider Business Practice Location Address
First Line	:	1650 SELWYN AVE
Second Line	:	ACN MORRIS
City	:	BRONX
State	:	NY
Zip	:	10457-7626
Country	:	US
Telephone Number	:	718-960-1235
Fax Number	:	718-960-1051

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

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	07/08/2007

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