Individual
ANDREA MARIE KHLEVNOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 DATES DR, ITHACA, NY 14850-1342
(607) 274-4296
(607) 274-4198
Mailing address
101 DATES DR, ITHACA, NY 14850-1342
(607) 274-4296
(607) 274-4198
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
318034
NY
207R00000X
Internal Medicine Physician
4351045717
MI
Other
Enumeration date
06/20/2019
Last updated
10/06/2023
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