# MEDISOL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003279308
- **Authorized official:** DR. TAHIR KHWAJA MD (PRESIDENT)
- **Authorized official phone:** (917) 287-8207

## Contact information

- **Practice address:** 226 FISHER AVE, PISCATAWAY, NJ 08854-4833
- **Practice address phone:** (214) 444-9864
- **Mailing address:** 10201 PERKINS DR, IRVING, TX 75063-5365
- **Mailing address phone:** (214) 444-9864

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/04/2016
- **Last updated:** 04/04/2016