Individual
KHVICHA BERULAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1539 FRANKLIN AVE RM 301, MINEOLA, NY 11501-4835
(347) 781-6115
Mailing address
1539 FRANKLIN AVE RM 301, MINEOLA, NY 11501-4835
(347) 781-6115
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2127903-DCWP
NY
Other
Enumeration date
12/26/2025
Last updated
12/26/2025
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