Individual
DR. KHALIDA ITRIYEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
410 LAKEVILLE RD STE 108, NEW HYDE PARK, NY 11042
(516) 465-3270
(516) 465-5299
Mailing address
10525 67TH RD APT 5H, FOREST HILLS, NY 11375-2398
(201) 207-1196
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
266549
NY
Other
Enumeration date
05/19/2011
Last updated
08/30/2018
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