Basic Information
| Provider Information | |||||||||
| NPI: | 1255430682 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHAZINA | ||||||||
| FirstName: | MARGARITA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6501 BAY PKWY | ||||||||
| Address2: | APT. 5C | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112043948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188715370 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1670-78 EAST 17TH STREET | ||||||||
| Address2: | 3RD. FL. | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183751200 | ||||||||
| FaxNumber: | 7183823358 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | R057214-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.