Healthcare Provider Details

I. General information

NPI: 1700405818
Provider Name (Legal Business Name): ARIELLA KASHI KHAITOV MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ARIELLA KASHI MD

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WOODS RD
VALHALLA NY
10595-1530
US

IV. Provider business mailing address

10 MOUNTAIN LN
HOLMDEL NJ
07733-1107
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-7000
  • Fax:
Mailing address:
  • Phone: 732-239-0399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME162861
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: