Provider Demographics
NPI:1780216762
Name:HANAN KHAIRALLA MD, LLC
Entity Type:Organization
Organization Name:HANAN KHAIRALLA MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAIRALLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-354-1872
Mailing Address - Street 1:290 TURNPIKE RD STE 150-370
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2843
Mailing Address - Country:US
Mailing Address - Phone:781-354-1872
Mailing Address - Fax:
Practice Address - Street 1:6 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748
Practice Address - Country:US
Practice Address - Phone:781-354-1872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health