Basic Information
| Provider Information | |||||||||
| NPI: | 1598115594 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHOKHAR | ||||||||
| FirstName: | RABEA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4400 CARLISLE PIKE | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171041612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7179759800 | ||||||||
| FaxNumber: | 7179755509 | ||||||||
| Practice Location | |||||||||
| Address1: | 4400 CARLISLE PIKE | ||||||||
| Address2: | |||||||||
| City: | CAMP HILL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170114132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7179759800 | ||||||||
| FaxNumber: | 7179755509 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2016 | ||||||||
| LastUpdateDate: | 12/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD469171 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.