Individual
MARIA KHODAKOVSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2 HIGH ST, MONTICELLO, NY 12701-1343
(845) 791-8800
(845) 791-7051
Mailing address
7292 STATE ROUTE 42, GRAHAMSVILLE, NY 12740-7004
(845) 707-3933
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
554618-01
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F407294
NY
Other
Enumeration date
12/11/2024
Last updated
07/31/2025
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