Provider Demographics
NPI:1801275383
Name:ALIKHAN, GHOUSIA (MD)
Entity type:Individual
Prefix:DR
First Name:GHOUSIA
Middle Name:
Last Name:ALIKHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 BEECH ST STE 402
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-2223
Mailing Address - Country:US
Mailing Address - Phone:413-534-2682
Mailing Address - Fax:413-534-2689
Practice Address - Street 1:575 BEECH ST STE 402
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040
Practice Address - Country:US
Practice Address - Phone:413-534-2682
Practice Address - Fax:413-534-2689
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA274610207RR0500X
390200000X
NJ25MA11163600207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program