Most Relevant Information
Provider Data
| NPI Number: | 1003244351 |
| Provider Name: | IRINA KHAYTMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/24/2013 |
| Last Updated: | 10/24/2013 |
Provider Practice Location
19 GEOFFREY LN
HEWLETT
NY
115571002
Practice Location Phone/Fax
| Phone: | 9173658181 |
| Fax: |
Provider Mailing Location
19 GEOFFREY LN
HEWLETT
NY
115571002
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |