Provider Demographics
NPI:1760566848
Name:KHAIT, ALEX (DC, BS)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:
Last Name:KHAIT
Suffix:
Gender:M
Credentials:DC, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2343 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6325
Mailing Address - Country:US
Mailing Address - Phone:917-676-7770
Mailing Address - Fax:
Practice Address - Street 1:8 CLINTON PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-1707
Practice Address - Country:US
Practice Address - Phone:917-676-7770
Practice Address - Fax:718-690-3580
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010266111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02264717Medicaid