Individual
MR. ALBERT KHANIMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
9701 66TH AVE, REGO PARK, NY 11374-4245
(718) 423-0808
Mailing address
9701 66TH AVE, REGO PARK, NY 11374-4245
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
012445
NY
Other
Enumeration date
02/05/2009
Last updated
06/05/2023
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