Provider Demographics
NPI:1063873412
Name:KHAIMOV, ARTUR (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ARTUR
Middle Name:
Last Name:KHAIMOV
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:ARTHUR
Other - Middle Name:
Other - Last Name:KHAIMOV
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:7126 YELLOWSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3540
Mailing Address - Country:US
Mailing Address - Phone:718-314-6153
Mailing Address - Fax:
Practice Address - Street 1:7126 YELLOWSTONE BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3540
Practice Address - Country:US
Practice Address - Phone:718-314-6153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061131183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist