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NPI Code Detail

MEDICARE: ANZHELIKA KHAITOVA PHARM. D

MEDICARE:   ANZHELIKA  KHAITOVA  PHARM. D
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
1183500000XPharmacist060003NY

General Provider Information

NPI Number : 1700281888
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANZHELIKA KHAITOVA PHARM. D
Provider Business Mailing Address
First Line : 1637 YORK AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10028-6545
Country : US
Telephone Number : 212-534-2000
Fax Number :
Provider Business Practice Location Address
First Line : 1637 YORK AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10028-6545
Country : US
Telephone Number : 646-764-4939
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2014
Last Update Date : 12/21/2018

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Directions to “ ANZHELIKA KHAITOVA PHARM. D” Practice Location

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