Healthcare Provider Details

I. General information

NPI: 1528542289
Provider Name (Legal Business Name): AIM HEALTH INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2018
Last Update Date: 09/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 NEW HAMPSHIRE AVE NW STE 200
WASHINGTON DC
20037-2334
US

IV. Provider business mailing address

908 NEW HAMPSHIRE AVE NW STE 200
WASHINGTON DC
20037-2334
US

V. Phone/Fax

Practice location:
  • Phone: 202-833-5055
  • Fax: 202-833-5755
Mailing address:
  • Phone: 202-833-5055
  • Fax: 202-833-5755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MIKHAIL KOGAN
Title or Position: CHAIR OF THE BOARD
Credential: MD
Phone: 202-833-5055