Provider Demographics
NPI:1710365879
Name:KHOJA, ALIA MAHMOUD (MD)
Entity Type:Individual
Prefix:DR
First Name:ALIA
Middle Name:MAHMOUD
Last Name:KHOJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1290 SILAS DEANE HWY
Mailing Address - Street 2:HARTFORD HEALTHCARE-CVO
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 SEABURY DR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-5618
Practice Address - Country:US
Practice Address - Phone:860-380-5150
Practice Address - Fax:860-726-2230
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2021038959207RG0300X
CT70362207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine