=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992052435
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FOOT AND ANKLE CENTER OF MASSACHUSETTS PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2012
-----------------------------------------------------
Last Update Date | 05/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 230 LOWELL ST 2ND FLOOR, UNITS C & E
-----------------------------------------------------
City | WILMINGTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01887-3087
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-658-1700
-----------------------------------------------------
Fax | 978-658-1707
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 230 LOWELL ST 2ND FLOOR, UNITS C & E
-----------------------------------------------------
City | WILMINGTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01887-3087
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-658-1700
-----------------------------------------------------
Fax | 978-658-1707
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. FILZA KHAN
-----------------------------------------------------
Credential | D.P.M
-----------------------------------------------------
Telephone | 978-658-1700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | 2329
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------