Individual
DEMIS KHAIMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14136 73RD AVE, FLUSHING, NY 11367-2320
(347) 556-5670
Mailing address
14136 73RD AVE, FLUSHING, NY 11367-2320
(347) 556-5670
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
017124-1
NY
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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