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1740575067 NPI number — MEHNAZ KHAN M.D.

NPI Number: 1740575067
Health Care Provider/Practitioner: MEHNAZ KHAN M.D.

Information about “1740575067” NPI (MEHNAZ KHAN M.D.) exists in 1740575067 in HTML format HTML  |  1740575067 in plain Text format TXT  |  1740575067 in PDF (Portable Document Format) PDF  |  1740575067 in an XML format XML  formats.

NPI Number : 1740575067 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740575067",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KHAN",
    "FirstName": "MEHNAZ",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "111 GROSSMAN DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BRAINTREE",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "02184-4997",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "781-849-2295",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "111 GROSSMAN DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BRAINTREE",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "02184-4997",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "781-849-2295",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/15/2011",
    "LastUpdateDate": "03/04/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207W00000X",
          "TaxonomyName": "Ophthalmology Physician",
          "LicenseNumber": "126056",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207WX0107X",
          "TaxonomyName": "Retina Specialist (Ophthalmology) Physician",
          "LicenseNumber": "35126056",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207W00000X",
          "TaxonomyName": "Ophthalmology Physician",
          "LicenseNumber": "281229",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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