Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 232910 | NY |
Y | 111NI0900X | Internist | 232910 | NY |
N | 207RA0401X | Internist - Addiction Medicine | 232910 | NY |
N | 207RG0300X | Geriatric Medicine | 232910 | NY |
N | 207RH0002X | Hospice and Palliative Medicine | 232910 | NY |
NPI | 1134216617 |
---|---|
Provider Name | Dr. Mark Khaykin |
First Address | Brooklyn, NY 11235-1605 |
Second Address | Brooklyn, NY 11203-2054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 13/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I22701 | (02) |