Basic Information
| Provider Information | |||||||||
| NPI: | 1770108037 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EL KILANY | ||||||||
| FirstName: | MOHAMMAD | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 CAMELOT CT APT 5J | ||||||||
| Address2: | |||||||||
| City: | BRIGHTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021356149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3109976869 | ||||||||
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| Practice Location | |||||||||
| Address1: | 736 CAMBRIDGE ST | ||||||||
| Address2: | |||||||||
| City: | BRIGHTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021352907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177895004 | ||||||||
| FaxNumber: | 6177895088 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2020 | ||||||||
| LastUpdateDate: | 06/12/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 283817 | MA | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.