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General NPI Number Information
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NPI Number | 1194957803
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Entity Type | Organization
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Legal Business Name | S. CHARLES KHANI, M.D. PHD, P.C.
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Dates
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Enumeration Date | 08/13/2009
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 900 CUMMINGS CTR SUITE 308V
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City | BEVERLY
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State | MA
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Zip | 01915-6198
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Country | US
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Telephone | 978-922-1344
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Fax | 978-922-1346
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Provider Business Mailing Address
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Address Line | 47 WALKER RD
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City | MANCHESTER
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State | MA
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Zip | 01944-1032
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Country | US
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Telephone | 978-922-1344
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Fax | 978-922-1346
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHAHROKH CHARLES KHANI
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Credential | M.D.
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Telephone | 978-922-1344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number |
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License Number State |
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