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General NPI Number Information
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NPI Number | 1356432652
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Entity Type | Individual
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Provider Name | RAFIK KHAIMOV MD
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 6509 99TH ST
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City | REGO PARK
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State | NY
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Zip | 11374-3570
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Country | US
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Telephone | 718-606-0023
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Fax | 718-606-2715
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Provider Business Mailing Address
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Address Line | 7126 YELLOWSTONE BLVD
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City | FOREST HILLS
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State | NY
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Zip | 11375-3540
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Country | US
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Telephone | 718-606-2700
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Fax | 718-606-2715
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 229933-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 229933
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License Number State | NY
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