Organization
FOOT AND ANKLE CENTER OF FORT LEE PODIATRY
Active
Other names
foot and ankle center of fort lee, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAVRIIL KHAIMOV DPM (PRESIDENT)
(201) 363-9844
Entity
Organization
Contact information
Practice address
14402 JEWEL AVE, SUITE A, FLUSHING, NY 11367-1744
(718) 263-3668
(718) 263-0028
Mailing address
14402 JEWEL AVE, SUITE A, FLUSHING, NY 11367-1744
(718) 263-3668
(718) 263-0028
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
N006045
NY
Other
Enumeration date
03/21/2014
Last updated
03/21/2014
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