DR. IGOR KHUTORETSKIY M/D NPI 1962462416

NPI Information

NPI: 1962462416
Provider Name: DR. IGOR KHUTORETSKIY, M/D
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
5205 CHURCH AVE
BROOKLYN, NY
ZIP 11203
Phone: (718) 688-8000
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DR. Igor Khutoretskiy, M/D is a specialist in Brooklyn, NY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Igor Khutoretskiy, M/D NPI is 1962462416. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5205 CHURCH AVE
BROOKLYN, NY
ZIP 11203-513
Phone: (718) 688-8000
Fax: (718) 385-5104

The enumeration date for this NPI number is 3/27/2006 and was last updated on 2/14/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		214430	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	H04650	MEDICARE UPIN	NEW YORK
2	9Y0872	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK
3	01952469	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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