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KHAIMOV PEDIATRICS PLLC NPI 1447508064


NPI Information

NPI: 1447508064
Provider Name: KHAIMOV PEDIATRICS PLLC

Former Legal Business Name: RAFIK KHAIMOV MEDICAL PC

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 33D2020519

Address:
64-05 YELLOWSTONE BLVD
CF104
FOREST HILLS, NY
ZIP 11375
Phone: (718) 606-2700
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KHAIMOV PEDIATRICS PLLC is a pediatrics in Forest Hills, NY. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. KHAIMOV PEDIATRICS PLLC NPI is 1447508064. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Rafik Khaimov Medical Pc.

The provider's business location address is:

64-05 YELLOWSTONE BLVD
CF104
FOREST HILLS, NY
ZIP 11375-656
Phone: (718) 606-2700
Fax: (718) 606-2715

The provider's authorized official is Rafik Khaimov .
The authorized official title is President and has the following contact phone number (917) 776-3092.

The CLIA number assigned to this NPI record is 33D2020519 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/29/2012 and was last updated on 8/29/2012.


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
1208000000XPediatricsNEW YORKYes

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 Other Provider Identifier Issuer
102568129MEDICAIDNEW 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: 5/5/2024

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