1225285117 NPI number — DR. SALMAAN A. KHAWAJA PSY.D., ED.S.

Table of content: DR. SALMAAN A. KHAWAJA PSY.D., ED.S. (NPI 1225285117)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225285117 NPI number — DR. SALMAAN A. KHAWAJA PSY.D., ED.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHAWAJA
Provider First Name:
SALMAAN
Provider Middle Name:
A.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSY.D., ED.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225285117
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/30/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11601 IRON BRIDGE RD
Provider Second Line Business Mailing Address:
SUITE 207
Provider Business Mailing Address City Name:
CHESTER
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23831-1466
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-285-6880
Provider Business Mailing Address Fax Number:
804-706-1585

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11601 IRON BRIDGE RD
Provider Second Line Business Practice Location Address:
SUITE 207
Provider Business Practice Location Address City Name:
CHESTER
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23831-1466
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-285-6880
Provider Business Practice Location Address Fax Number:
804-706-1585
Provider Enumeration Date:
08/21/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  0810004012 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: C09633 . This is a "GROUP PTAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com