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General NPI Number Information
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NPI Number | 1811160765
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Entity Type | Organization
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Legal Business Name | KHAN CLINICAL ASSOCIATES
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 2000 WASHINGTON ST # 402
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City | NEWTON
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State | MA
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Zip | 02462-1650
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Country | US
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Telephone | 617-527-0239
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Fax | 617-527-0157
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Provider Business Mailing Address
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Address Line | 2000 WASHINGTON ST # 402
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City | NEWTON
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State | MA
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Zip | 02462-1650
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Country | US
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Telephone | 617-527-0239
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Fax | 617-527-0157
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Authorized Official
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Title or Position | OWNER
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Name | DR. NASIR A KHAN
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Credential | MD
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Telephone | 617-527-0239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 31809
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 31809
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License Number State | MA
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