# TATYANA AND DMITRY KHODIK, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114391836
- **Authorized official:** MR. DMITRY KHODIK M.ED. (SPECIAL EDUCATION TEACHER)
- **Authorized official phone:** (917) 613-4028

## Contact information

- **Practice address:** 22215 KINGSBURY AVE, OAKLAND GARDENS, NY 11364-3649
- **Practice address phone:** (917) 613-4028
- **Mailing address:** 222-15 KINGSBURY AVE, OAKLAND GARDENS, NY 11364-3649
- **Mailing address phone:** (917) 613-4028

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NY | Yes |

## Other

- **Enumeration date:** 11/18/2015
- **Last updated:** 11/18/2015