Provider Demographics
NPI:1760681894
Name:KHAN, FILZA (DPM)
Entity Type:Individual
Prefix:
First Name:FILZA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 LOWELL ST
Mailing Address - Street 2:2ND FLOOR, UNITS C & E
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-3087
Mailing Address - Country:US
Mailing Address - Phone:978-658-1700
Mailing Address - Fax:978-658-1707
Practice Address - Street 1:230 LOWELL ST
Practice Address - Street 2:2ND FLOOR, UNITS C & E
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-3087
Practice Address - Country:US
Practice Address - Phone:978-658-1700
Practice Address - Fax:978-658-1707
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2012-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2329213E00000X
CT000836213ES0103X, 213EP1101X, 213ER0200X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT030000836CT01OtherANTHEM BCBS
CT06-1406459OtherMULTIPLAN
CT4287303OtherCIGNA
CT06-0406459OtherGREAT-WEST HEALTHCARE
CT06-1406459OtherNORTHEAST HEALTH DIRECT
CT06-1406459OtherCORVEL
CT06-0406459OtherUNITED HEALTHCARE
CT201836OtherCONNECTICARE
CT3V0711OtherHEALTH NET
CT9147180OtherAETNA
CT06-1406459OtherPRIVATE HEALTHCARE SYSTEMS
CT06-1406459OtherCOMMUNITY HEALTH NETWORK
CT06-1406459OtherTRICARE
CT1760681894Medicaid
CT4287303OtherCIGNA