Individual
BORIS KHAIMOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O,
Contact information
Practice address
11 GRACE AVE STE 204, GREAT NECK, NY 11021-2417
(917) 551-6652
Mailing address
6725 DARTMOUTH ST, 3N, FOREST HILLS, NY 11375-4058
(171) 826-3382
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
249224
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/22/2007
Last updated
02/15/2022
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