Individual
DR. DMITRIY KHAZRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-1008
Mailing address
915 EAST 7 STREET, APT. 5G, BROOKLYN, NY 11230
(718) 338-3247
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051901
NY
207R00000X
Internal Medicine Physician
Primary
279834
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01580634
—
NY
Enumeration date
12/27/2007
Last updated
07/02/2015
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