Individual
YULIANNA KHAIMOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15330 77TH RD, FLUSHING, NY 11367-3425
(917) 769-2067
Mailing address
15330 77TH RD, FLUSHING, NY 11367-3425
(917) 769-2067
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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