Clear Mind Psychiarty of Manhattan

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

CLEAR MIND PSYCHIARTY OF MANHATTAN

Practice address

276 5TH Ave RM 1101
New York, NY 10001-4544

Phone

(917) 981-9086

Fax

(917) 477-2278

NPI assigned

Dec 11, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Boris A Khaimov, DO

Title

Psychiatry

Phone

(917) 981-9086

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1013555861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6238 DIETERLE CRES",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744836",
            "telephone_number": "917-981-9086",
            "fax_number": "917-477-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 5TH AVE RM 1101",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014544",
            "telephone_number": "917-981-9086",
            "fax_number": "917-477-2278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Grace Ave Ste 204C",
            "address_purpose": "LOCATION",
            "city": "Great Neck",
            "state": "NY",
            "postal_code": "110212417",
            "country_code": "US",
            "telephone_number": "917-551-6652 x1",
            "fax_number": "917-477-2278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLEAR MIND PSYCHIARTY OF MANHATTAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "KHAIMOV",
        "authorized_official_first_name": "BORIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PSYCHIATRY",
        "authorized_official_telephone_number": "917-981-9086",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.