Individual
MARK KHAIMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1810 AVENUE N APT 3E, BROOKLYN, NY 11230-6162
(718) 844-8278
Mailing address
1810 AVENUE N APT 3E, BROOKLYN, NY 11230-6162
(718) 844-8278
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
352395
NY
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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