Individual
DR. GAVRIIL KHAIMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
185 BRIDGE PLZ N, SUITE #4, FORT LEE, NJ 07024-5907
(201) 363-9844
Mailing address
6909 138TH ST, 2C, FLUSHING, NY 11367-1603
(718) 263-4013
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
25MD00295000
NJ
213ES0103X
Foot & Ankle Surgery Podiatrist
N006045
NY
Other
Enumeration date
08/10/2006
Last updated
10/01/2011
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