Individual
MR. BORIS KHAIMOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
8401 MAIN ST, SUITE#416, BRIARWOOD, NY 11435-1722
(718) 431-5251
(718) 830-1149
Mailing address
8401 MAIN ST, SUITE#416, BRIARWOOD, NY 11435-1722
(718) 431-5251
(718) 830-1149
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
007580
NY
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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