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Provider Information for 1720212715

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

ALISA KHAN MD

Gender: FEMALE

Individual NPI: 1720212715

Calendar   Last Updated:  2012-07-06
  Certification Date: 

Details

Name Value
NPI 1720212715
Enumeration Date 2009-05-06
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 303 THIRD ST #615
CAMBRIDGE, MA 02142-1156
United States

Phone: 410-736-3399 | Fax:
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Primary Practice Address 300 LONGWOOD AVE, AU-521, CHILDREN'S HOSPITAL BOSTON HARVARD PEDIATRIC HEALTH SERVICES RESEARCH FELLOWSHIP
BOSTON, MA 02115-5724
United States

Phone: 617-355-8298 | Fax: 617-730-0174
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Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 208000000X - Pediatrics MA 250817
No 390200000X - Student in an Organized Health Care Education/Training Program MD