MEDICARE: DR. NATALLIA KHAMENKA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	102L00000X	Psychoanalyst	001279-03	NY

General Provider Information

NPI Number	:	1023969953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATALLIA KHAMENKA

Provider Business Mailing Address
First Line	:	11 GATE HOUSE LN
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08820-4002
Country	:	US
Telephone Number	:	929-939-7567
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 W 74TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-2401
Country	:	US
Telephone Number	:	929-939-7567
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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