Individual
MR. ANDREY KHABURSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
285 FARMVIEW DR, MACEDON, NY 14502-9329
(585) 491-0964
Mailing address
285 FARMVIEW DR, MACEDON, NY 14502-9329
(585) 491-0964
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
334542
NY
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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