Provider Demographics
NPI:1396991881
Name:KHADER ELIYAS, JAVED (MD)
Entity type:Individual
Prefix:DR
First Name:JAVED
Middle Name:
Last Name:KHADER ELIYAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ASYLUM AVE STE 3215
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1702
Mailing Address - Country:US
Mailing Address - Phone:860-714-6980
Mailing Address - Fax:
Practice Address - Street 1:1000 ASYLUM AVE STE 3215
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1702
Practice Address - Country:US
Practice Address - Phone:860-714-6980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY325495207T00000X
NMMD2017-1071207T00000X
CT71453207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery