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General NPI Number Information
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NPI Number | 1457532194
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Entity Type | Organization
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Legal Business Name | F KHAJAVI MD FACP INC
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Dates
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Enumeration Date | 11/23/2007
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Last Update Date | 11/23/2007
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Provider Practice Location Address
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Address Line | 3 WOODLAND RD STE 418
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City | STONEHAM
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State | MA
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Zip | 02180-1714
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Country | US
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Telephone | 781-662-6213
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Fax | 781-665-9860
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Provider Business Mailing Address
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Address Line | 3 WOODLAND RD STE 418
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City | STONEHAM
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State | MA
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Zip | 02180-1714
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Country | US
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Telephone | 781-662-6213
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Fax | 781-665-9860
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FARROKH KHAJAVI
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Credential | M.D.
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Telephone | 781-662-6213
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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 |
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License Number State |
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