Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 00026821 | AL |
NPI | 1043293798 |
---|---|
Provider Name | Lev Mark Khitin |
First Address | New York, NY 10004-1072 |
Second Address | Brooklyn, NY 11215-6054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2005 |
Last Update Date | 10/02/2016 |