Healthcare Provider Details

I. General information

NPI: 1952978355
Provider Name (Legal Business Name): DOWNTOWN MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2021
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 HENRY ST SUITE 1G
BROOKLYN NY
11201-2526
US

IV. Provider business mailing address

200 BROADWAY
BROOKLYN NY
11211
US

V. Phone/Fax

Practice location:
  • Phone: 718-521-2424
  • Fax:
Mailing address:
  • Phone: 718-302-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL KHAIMOV
Title or Position: PRESIDENT
Credential: MD
Phone: 718-521-2424