Organization
TATYANA AND DMITRY KHODIK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DMITRY KHODIK M.ED. (SPECIAL EDUCATION TEACHER)
(917) 613-4028
Entity
Organization
Contact information
Practice address
22215 KINGSBURY AVE, OAKLAND GARDENS, NY 11364-3649
(917) 613-4028
Mailing address
222-15 KINGSBURY AVE, OAKLAND GARDENS, NY 11364-3649
(917) 613-4028
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
NY
Other
Enumeration date
11/18/2015
Last updated
11/18/2015
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