Individual
ALEXANDRA KHANYUTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
183 S ORANGE AVE, BHSB, E-1452, NEWARK, NJ 07103-2757
(973) 972-4678
Mailing address
530 NEW BRUNSWICK AVE, PERTH AMBOY, NJ 08861-3654
(732) 324-5138
(732) 324-5139
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA10126000
NJ
2084P0800X
Psychiatry Physician
293027
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2014
Last updated
06/14/2022
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