Individual
MARINA KHAIMOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6326B BOURTON ST, 1B, REGO PARK, NY 11374-2842
(917) 667-4271
Mailing address
6326B BOURTON ST, 1B, REGO PARK, NY 11374-2842
(917) 667-4271
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
010258
NY
Other
Enumeration date
01/15/2016
Last updated
01/15/2016
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