Individual
DR. CHAZA KHALIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1055 HAMBURG TPKE STE 200, WAYNE, NJ 07470-3235
(973) 248-1440
(973) 248-1448
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA09587100
NJ
261Q00000X
Clinic/Center
265909
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
265909
NY STATE LICENSE NUMBER
NY
Enumeration date
01/11/2012
Last updated
05/10/2018
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