Individual
DR. DMITRIY O. KHODORSKIY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
222 STATION PLZ N STE 429, MINEOLA, NY 11501-3889
(516) 663-4623
(516) 663-8500
Mailing address
222 STATION PLZ N STE 429, MINEOLA, NY 11501-3889
(516) 663-4623
(516) 663-8500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
054753
CT
207R00000X
Internal Medicine Physician
265957
NY
207R00000X
Internal Medicine Physician
A132741
CA
207RG0100X
Gastroenterology Physician
054753
CT
207RG0100X
Gastroenterology Physician
Primary
265957
NY
207RG0100X
Gastroenterology Physician
A132741
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03530641
—
NY
Enumeration date
07/10/2009
Last updated
06/06/2017
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