Provider Demographics
NPI:1679768220
Name:KHUSHRU IRANI
Entity type:Organization
Organization Name:KHUSHRU IRANI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KHUSHRU
Authorized Official - Middle Name:
Authorized Official - Last Name:IRANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-688-0122
Mailing Address - Street 1:2210 TROY RD
Mailing Address - Street 2:
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-4725
Mailing Address - Country:US
Mailing Address - Phone:518-688-0122
Mailing Address - Fax:518-688-0125
Practice Address - Street 1:2210 TROY RD
Practice Address - Street 2:
Practice Address - City:NISKAYUNA
Practice Address - State:NY
Practice Address - Zip Code:12309-4725
Practice Address - Country:US
Practice Address - Phone:518-688-0122
Practice Address - Fax:518-688-0125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143963207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty