Individual
KHAULA KHALID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
946 BLOOMFIELD AVE, GLEN RIDGE, NJ 07028-1308
(973) 743-1121
Mailing address
946 BLOOMFIELD AVE, GLEN RIDGE, NJ 07028-1308
(973) 743-1121
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MB08277700
NJ
207RC0000X
Cardiovascular Disease Physician
Primary
25MB08277700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0167428
—
NJ
01
—
47928
UHP NON PAR #
NJ
01
—
P00650715
RAILROAD MEDICARE
NJ
Enumeration date
05/06/2008
Last updated
04/05/2011
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