# FOOT AND ANKLE CENTER OF FORT LEE PODIATRY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** foot and ankle center of fort lee, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285051797
- **Authorized official:** DR. GAVRIIL KHAIMOV DPM (PRESIDENT)
- **Authorized official phone:** (201) 363-9844

## Contact information

- **Practice address:** 14402 JEWEL AVE, SUITE A, FLUSHING, NY 11367-1744
- **Practice address phone:** (718) 263-3668
- **Practice address fax:** (718) 263-0028
- **Mailing address:** 14402 JEWEL AVE, SUITE A, FLUSHING, NY 11367-1744
- **Mailing address phone:** (718) 263-3668
- **Mailing address fax:** (718) 263-0028

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | N006045 | NY | Yes |

## Other

- **Enumeration date:** 03/21/2014
- **Last updated:** 03/21/2014