NPI Code Detail JSON Logo

1124257928 NPI number — KHALED E EISSA MD

NPI Number: 1124257928
Health Care Provider/Practitioner: KHALED E EISSA MD

Information about “1124257928” NPI (KHALED E EISSA MD) exists in 1124257928 in HTML format HTML  |  1124257928 in plain Text format TXT  |  1124257928 in PDF (Portable Document Format) PDF  |  1124257928 in an XML format XML  formats.

NPI Number : 1124257928 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124257928",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "EISSA",
    "FirstName": "KHALED",
    "MiddleName": "E",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "EISSA",
    "OtherFirstName": "KHALED",
    "OtherMiddleName": "ELSAYED AHMED",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "BMCHS PROVIDER ENROLLMENT",
    "SecondLineMailingAddress": "960 MASSACHUSETTS AVE FLR 2",
    "MailingAddressCityName": "BOSTON",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "02118",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "LAHEY HOSPITAL AND MEDICAL CTR 41 MALL ROAD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BURLINGTON",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "01805-0001",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "781-744-8000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/14/2009",
    "LastUpdateDate": "03/11/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207RP1001X",
          "TaxonomyName": "Pulmonary Disease Physician",
          "LicenseNumber": "266466",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RC0200X",
          "TaxonomyName": "Critical Care Medicine (Internal Medicine) Physician",
          "LicenseNumber": "266466",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.