Individual
GREGORY KHAIMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10236 64TH AVE APT 4E, FOREST HILLS, NY 11375-1504
(646) 463-3927
Mailing address
10236 64TH AVE APT 4E, FOREST HILLS, NY 11375-1504
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
021355-1
NY
Other
Enumeration date
11/20/2017
Last updated
05/20/2020
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