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General NPI Number Information
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NPI Number | 1043544166
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Entity Type | Individual
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Provider Name | DMITRIY KHELEMSKIY L.AC
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Gender | Male
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Dates
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Enumeration Date | 09/22/2009
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Last Update Date | 09/22/2009
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Provider Practice Location Address
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Address Line | 10520 CROSSBAY BLVD
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City | OZONE PARK
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State | NY
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Zip | 11417-1515
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Country | US
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Telephone | 718-641-6561
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Fax |
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Provider Business Mailing Address
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Address Line | 915 84 STREET, APT 3A
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City | BROOKLYN
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State | NY
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Zip | 11228
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Country | US
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Telephone | 718-833-2036
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 4012
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License Number State | NY
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