Mohamed Khatib

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

0016495 Issued in CT

Practice address

24 Pershing Dr
Ansonia, CT 06401-2214

Phone

(203) 735-7837

NPI assigned

Jan 1, 2024

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704067200000",
    "number": "1285403246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 SCHILLER RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068251136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PERSHING DR",
            "city": "ANSONIA",
            "state": "CT",
            "postal_code": "064012214",
            "telephone_number": "203-735-7837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATIB",
        "first_name": "MOHAMED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-01",
        "last_updated": "2024-01-01",
        "certification_date": "2023-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CT",
            "license": "0016495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julienne Dudzis, DPM
• Roy E. Kalman, M.D.
• Natasha Kelly, M.D.
• Taylor Kelly, APRN
• Aisha Khan, MD
• Alexandra Kitchener, LCSW
• Marci Klein, M.D.
• Lauren Edna Kopka, LCSW
• Vallari Kothari, M.D.
• Anna Kucharczyk

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Ansonia, CT
• Providers in Ansonia, CT by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.