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General NPI Number Information
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NPI Number | 1366862104
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Entity Type | Individual
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Provider Name | HANAN KHAIRALLA MD
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Gender | Female
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Dates
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Enumeration Date | 04/20/2014
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 143 NEWBURY ST STE 400
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City | BOSTON
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State | MA
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Zip | 02116-2954
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Country | US
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Telephone | 781-354-1872
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Fax | 430-206-2273
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Provider Business Mailing Address
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Address Line | 143 NEWBURY ST ST 400
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City | BOSTON
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State | MA
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Zip | 02116-2925
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Country | US
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Telephone | 781-354-1872
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Fax | 430-206-2273
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA10189700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 277009
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License Number State | MA
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