Irina Khaimovich

Primary specialty

SpecialistTaxonomy code 174400000X

License

1823038241 Issued in NY

Practice address

2571 E 17TH St
Brooklyn, NY 11235-3585

Phone

(929) 371-2131

NPI assigned

May 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Irina Poltorak Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bright Buds Garden LLC

  • Early Intervention Provider Agency
  • Brooklyn, NY
  • NPI 1316751159
  NPD Authorized official

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1821589011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2819 W 12TH ST APT 3N",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112243118",
            "telephone_number": "917-420-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2571 E 17TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353585",
            "telephone_number": "929-371-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIMOVICH",
        "first_name": "IRINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1823038241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRINA",
            "last_name": "POLTORAK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Regina Khaimov, SLP CF
• Chaya M Khaimova
• Diana Khaimova
• Inna Khaimova
• Rebecca Madeline Khaimova, PHARMD
• Ali J Khaireddine, DPM
• Norah Aisha Khairy
• Khait Medical Care, P.C.
• Amy Khait
• Eugene Khait, M.D.

• Specialist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.