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1447877592
MIRENA KHAIMOVA
STATEN ISLAND, NY
NPI
1447877592
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NY F342807-1)
Enumeration Date
2020-07-05
Last Update Date
2020-07-05
Business Address
MIRENA KHAIMOVA
302 GETZ AVE
STATEN ISLAND, NY 10312-2433
Phone number: 917-833-7391
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Mailing Address
MIRENA KHAIMOVA
302 GETZ AVE
STATEN ISLAND, NY 10312-2433
Phone number: 917-833-7391
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