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Organization
MEDISOL, LLC
Active
Organization
MEDISOL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAHIR KHWAJA MD (PRESIDENT)
(917) 287-8207
Entity
Organization
Contact information
Practice address
226 FISHER AVE, PISCATAWAY, NJ 08854-4833
(214) 444-9864
Mailing address
10201 PERKINS DR, IRVING, TX 75063-5365
(214) 444-9864
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
NULL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Enumeration date
04/04/2016
Last updated
04/04/2016
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