1760681894 NPI number — FILZA KHAN D.P.M.

Table of content: FILZA KHAN D.P.M. (NPI 1760681894)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760681894 NPI number — FILZA KHAN D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHAN
Provider First Name:
FILZA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.P.M.
Provider Gender Code:
F

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:
1760681894
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
230 LOWELL ST
Provider Second Line Business Mailing Address:
2ND FLOOR, UNITS C & E
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01887-3087
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-658-1700
Provider Business Mailing Address Fax Number:
978-658-1707

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
230 LOWELL ST
Provider Second Line Business Practice Location Address:
2ND FLOOR, UNITS C & E
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01887-3087
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-658-1700
Provider Business Practice Location Address Fax Number:
978-658-1707
Provider Enumeration Date:
07/18/2007

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: 213E00000X , with the licence number:  2329 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 213ES0103X , with the licence number: 000836 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213EP1101X , with the licence number: 000836 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213ER0200X , with the licence number: 000836 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213E00000X , with the licence number: 000836 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 030000836CT01 . This is a "ANTHEM BCBS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "MULTIPLAN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 4287303 . This is a "CIGNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-0406459 . This is a "GREAT-WEST HEALTHCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "NORTHEAST HEALTH DIRECT" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "CORVEL" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-0406459 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 201836 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 3V0711 . This is a "HEALTH NET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 9147180 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "PRIVATE HEALTHCARE SYSTEMS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "COMMUNITY HEALTH NETWORK" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1406459 . This is a "TRICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1760681894 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".




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