NPIMap

Organization Active NPI

Tatyana and Dmitry Khodik, LLC

  • Early Intervention Provider Agency
  • Oakland Gardens, NY
National Provider Identifier
1114391836
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
TATYANA AND DMITRY KHODIK, LLC
Practice address
22215 Kingsbury Ave
Oakland Gardens, NY 11364-3649
Phone
(917) 613-4028
NPI assigned
Nov 18, 2015
Last updated
Nov 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Authorized official

Name
Mr. Dmitry Khodik, M.ED.NPI 1689936262
Title
Special Education Teacher
Phone
(917) 613-4028

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NY Primary

Addresses

Primary practice location

22215 Kingsbury Ave
Oakland Gardens, NY 11364-3649

Mailing address

222-15 Kingsbury Ave
Oakland Gardens, NY 11364-3649
Phone (917) 613-4028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1114391836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222-15 KINGSBURY AVE",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113643649",
            "telephone_number": "917-613-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22215 KINGSBURY AVE",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113643649",
            "telephone_number": "917-613-4028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TATYANA AND DMITRY KHODIK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "KHODIK",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "SPECIAL EDUCATION TEACHER",
        "authorized_official_telephone_number": "917-613-4028",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.ED."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.