Active NPI
Leonid Khalatov
- Psychiatry Physician
- Hewlett, NY
National Provider Identifier
1285899344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 175448
- Practice address
- 1453 Broadway
Hewlett, NY 11557-1426 - Phone
- (516) 792-0800
- NPI assigned
- Jul 28, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 175448 | NY | Primary |
Addresses
Primary practice location
1453 Broadway
Hewlett, NY 11557-1426
Mailing address
1453 Broadway
Hewlett, NY 11557-1426
Phone (516) 792-0800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 175448 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308873600000",
"number": "1285899344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1453 BROADWAY",
"city": "HEWLETT",
"state": "NY",
"postal_code": "115571426",
"telephone_number": "516-792-0800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1453 BROADWAY",
"city": "HEWLETT",
"state": "NY",
"postal_code": "115571426",
"telephone_number": "516-792-0800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHALATOV",
"first_name": "LEONID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-28",
"last_updated": "2011-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "175448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hewlett, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.