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Individual

JANNIKA DODGE KHATAMI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
376 E MAIN ST STE 102, BAY SHORE, NY 11706-8441
(631) 539-5400
Mailing address
376 E MAIN ST STE 102, BAY SHORE, NY 11706-8441
(631) 539-5400

Taxonomy

Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
292026
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
10/05/2014
Last updated
02/25/2021
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