Provider Demographics
NPI:1528307352
Name:KHAN, ALIYA AZIZ (MD)
Entity type:Individual
Prefix:
First Name:ALIYA
Middle Name:AZIZ
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:124 DEERFOOT RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-1701
Mailing Address - Country:US
Mailing Address - Phone:352-363-8462
Mailing Address - Fax:
Practice Address - Street 1:300 FRIBERG PKWY
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-3900
Practice Address - Country:US
Practice Address - Phone:508-329-6110
Practice Address - Fax:508-329-6088
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2808892084P0800X
FLTRN 181972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry