Active NPI
Mariam Khan
- Pharmacist
- Lowell, MA
National Provider Identifier
1457835662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH239390
- Practice address
- 161 Jackson St
Lowell, MA 01852-2103 - Phone
- (978) 937-9700
- Fax
- (978) 221-6728
- NPI assigned
- Sep 24, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19581-40 | WI | |
| Pharmacist | 183500000X | PH239390 | MA | Primary |
Addresses
Primary practice location
161 Jackson St
Lowell, MA 01852-2103
Mailing address
913 N Spring St Apt 307
Beaver Dam, WI 53916-1737
Phone (501) 766-8312
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH239390 | MA | MD | Pharmacist |
| 19581-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1457835662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "913 N SPRING ST APT 307",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539161737",
"telephone_number": "501-766-8312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 JACKSON ST",
"city": "LOWELL",
"state": "MA",
"postal_code": "018522103",
"telephone_number": "978-937-9700",
"fax_number": "978-221-6728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "MARIAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-24",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "19581-40",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH239390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lowell, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.