Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 227196 | NY |
N | 207ND0101X | MOHS-Micrographic Surgeon | 227196 | NY |
NPI | 1457374704 |
---|---|
Provider Name | Dr. Tatiana Khrom |
First Address | Brooklyn, NY 11235-7861 |
Second Address | Brooklyn, NY 11235-1123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 24/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3K2791 | (02) | NY |