Provider Demographics
NPI:1487614673
Name:KHANUJA, AJIT K (MD)
Entity type:Individual
Prefix:DR
First Name:AJIT
Middle Name:K
Last Name:KHANUJA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1444 MASSACHUSETTS AVE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-1600
Mailing Address - Country:US
Mailing Address - Phone:518-272-1212
Mailing Address - Fax:518-272-9228
Practice Address - Street 1:1444 MASSACHUSETTS AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-1600
Practice Address - Country:US
Practice Address - Phone:518-272-1212
Practice Address - Fax:518-272-9228
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2010-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY115191-12085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00436324Medicaid
NY50309BMedicare ID - Type Unspecified
NYD02308Medicare UPIN