Individual
YURI KHAIMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
6541 SAUNDERS ST APT 6E, REGO PARK, NY 11374-4206
(347) 527-8299
Mailing address
6541 SAUNDERS ST APT 6E, REGO PARK, NY 11374-4206
(347) 527-8299
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
027195-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027195-01
MASSAGE THERAPY
NY
Enumeration date
08/11/2022
Last updated
08/11/2022
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