Khaula Khatlani, MD is a medicare enrolled "Preventive Medicine - Preventive Medicine/occupational Environmental Medicine" physician in Bristol, Connecticut. Her current practice location is
975 Farmington Ave Ste 1, Bristol, Connecticut. You can reach out to her office (for appointments etc.) via phone at
(860) 589-0114.
Khaula Khatlani is licensed to practice in Connecticut (license number 66471) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1184930455.
Physician's Profile
Full Name | Khaula Khatlani |
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Gender | Female |
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Speciality | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine |
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Location | 975 Farmington Ave Ste 1, Bristol, Connecticut |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1184930455
- Provider Enumeration Date: 08/25/2010
- Last Update Date: 09/21/2020
Medicare PECOS Information:
- PECOS PAC ID: 2860728565
- Enrollment ID: I20190801000867
Medical Identifiers
Medical identifiers for Khaula Khatlani such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1184930455 | NPI | - | NPPES |
66471 | Other | CT | STATE LICENSE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | 4301096855 (Michigan) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | 57453 (Connecticut) | Secondary |
2083P0500X | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine | 66471 (Connecticut) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Khaula Khatlani is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Khaula Khatlani, MD 975 Farmington Ave Ste 1, Bristol, CT 06010-3964 Ph: (860) 589-0114 | Khaula Khatlani, MD 975 Farmington Ave Ste 1, Bristol, CT 06010-3964 Ph: (860) 589-0114 |
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