Active NPI
Foot and Ankle Center of Fort Lee Podiatry
- Foot & Ankle Surgery Podiatrist
- Flushing, NY
National Provider Identifier
1285051797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- N006045
- Legal business name
- FOOT AND ANKLE CENTER OF FORT LEE PODIATRY
- Practice address
- 14402 Jewel Ave
Suite a
Flushing, NY 11367-1744 - Phone
- (718) 263-3668
- Fax
- (718) 263-0028
- NPI assigned
- Mar 21, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Gavriil Khaimov, DPM
- Title
- President
- Phone
- (201) 363-9844
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | N006045 | NY | Primary |
Addresses
Primary practice location
14402 Jewel Ave
Suite a
Flushing, NY 11367-1744
Mailing address
14402 Jewel Ave
Suite a
Flushing, NY 11367-1744
Phone (718) 263-3668
Other names 1
- foot and ankle center of fort lee, LLC
National Provider Directory
National Provider Directory- Tax ID family
- Foot and Ankle Center of Fort Lee Podiatry
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Foot & Ankle Surgery Podiatrist
- Forest Hills, NY
- NPI 1639596547
Locations
14402 Jewel Ave
Ste A
Flushing, NY 11367
Phone (718) 263-3668
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Foot & Ankle Surgery Podiatrist
- Fort Lee, NJ
- NPI 1669483426
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395360000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1395360000000",
"number": "1285051797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14402 JEWEL AVE",
"address_2": "SUITE A",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113671744",
"telephone_number": "718-263-3668",
"fax_number": "718-263-0028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14402 JEWEL AVE",
"address_2": "SUITE A",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113671744",
"telephone_number": "718-263-3668",
"fax_number": "718-263-0028"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOOT AND ANKLE CENTER OF FORT LEE PODIATRY",
"organizational_subpart": "NO",
"enumeration_date": "2014-03-21",
"last_updated": "2014-03-21",
"status": "A",
"authorized_official_last_name": "KHAIMOV",
"authorized_official_first_name": "GAVRIIL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "201-363-9844",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "NY",
"license": "N006045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "foot and ankle center of fort lee, LLC",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.