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NPI Code Detail

MEDICARE: NATASHA BITA KHAZAI MD

MEDICARE: NATASHA BITA KHAZAI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RE0101XEndocrinology, Diabetes & Metabolism Physician56579GA
2207RE0101XEndocrinology, Diabetes & Metabolism Physician258992MA

General Provider Information

NPI Number : 1114927670
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATASHA BITA KHAZAI MD
Provider Business Mailing Address
First Line : 110 LIBERTY ST
Second Line :
City : BROCKTON
State : MA
Zip : 02301-5674
Country : US
Telephone Number : 508-894-0400
Fax Number : 508-894-0356
Provider Business Practice Location Address
First Line : 110 LIBERTY ST
Second Line :
City : BROCKTON
State : MA
Zip : 02301-5674
Country : US
Telephone Number : 508-894-0400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2005
Last Update Date : 04/12/2022

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