Healthcare Provider Details

I. General information

NPI: 1780772681
Provider Name (Legal Business Name): GALINA KHELEMSKY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1636 E 14TH ST STE 123
BROOKLYN NY
11229-1100
US

IV. Provider business mailing address

1636 E 14TH ST STE 1231
BROOKLYN NY
11229-1190
US

V. Phone/Fax

Practice location:
  • Phone: 718-375-9090
  • Fax: 718-375-6618
Mailing address:
  • Phone: 718-375-9090
  • Fax: 718-375-6618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number207972
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: