Michael Bryan Khodorkovsky, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

013757 Issued in NY

Practice address

100 Old Palisade Rd Apt 3711
Fort Lee, NJ 07024-7028

Phone

(347) 831-7984

NPI assigned

Sep 6, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MK Chiropractic Services PC

  • Chiropractor
  • Brooklyn, NY
  • NPI 1285447755
  NPD Authorized official

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1487430278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 OLD PALISADE RD APT 3711",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070247028",
            "telephone_number": "347-831-7984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 OLD PALISADE RD APT 3711",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070247028",
            "telephone_number": "347-831-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODORKOVSKY",
        "first_name": "MICHAEL",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00800100",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "013757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bo Ram Keum, RPH
• Gavriil Khaimov, DPM
• Lydia Khalil, DDS
• Nikhat P Khan, DMD.AEGD
• KHH Medical Care PC.
• In Kim-Yoo, D.D.S.,M.S.
• Amber Kim
• Amy Hyemee Kim, DNP
• Annie Kim
• Byongyool Alan Kim, D.M.D

• Chiropractor in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.