Provider Demographics
NPI:1295482560
Name:KHAIRA PSYCHIATRY, PLLC
Entity type:Organization
Organization Name:KHAIRA PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMREET
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-708-9104
Mailing Address - Street 1:205 E ST UNIT TH-1
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-2874
Mailing Address - Country:US
Mailing Address - Phone:617-209-9146
Mailing Address - Fax:
Practice Address - Street 1:205 E ST UNIT TH-1
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-2874
Practice Address - Country:US
Practice Address - Phone:559-708-9104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-07
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)