Basic Information
Provider Information | |||||||||
NPI: | 1588637755 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | KHER | ||||||||
FirstName: | SUCHARITA | ||||||||
MiddleName: | R | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | KAMDAR | ||||||||
OtherFirstName: | SUCHARITA | ||||||||
OtherMiddleName: | M | ||||||||
OtherNamePrefix: | DR. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | MD | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 800 WASHINGTON ST | ||||||||
Address2: | BOX 369 | ||||||||
City: | BOSTON | ||||||||
State: | MA | ||||||||
PostalCode: | 021111552 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6176366366 | ||||||||
FaxNumber: | 6176366361 | ||||||||
Practice Location | |||||||||
Address1: | 800 WASHINGTON ST | ||||||||
Address2: | BOX 369 | ||||||||
City: | BOSTON | ||||||||
State: | MA | ||||||||
PostalCode: | 021111552 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6176366366 | ||||||||
FaxNumber: | 6176366361 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/08/2006 | ||||||||
LastUpdateDate: | 04/12/2011 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 227716 | MA | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RC0200X | 227716 | MA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
ID | Type | State | Issuer | Description | BK9395927 | 01 | MA | DEA | OTHER |