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1255017042
DEANNA KHAVASOVA
FOREST HILLS, NY
NPI
1255017042
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: NY F310862-01)
Enumeration Date
2023-06-26
Last Update Date
2023-06-26
Business Address
DEANNA KHAVASOVA
71-20 110TH ST
FOREST HILLS, NY 11375
Phone number: 718-793-3200
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Mailing Address
DEANNA KHAVASOVA
102-41 63RD ROAD
FOREST HILLS, NY 11375
Phone number: 954-554-3783
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