Provider Demographics
NPI:1891056883
Name:KHALILI, MERAV
Entity Type:Individual
Prefix:MRS
First Name:MERAV
Middle Name:
Last Name:KHALILI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2276 E 1ST ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5144
Mailing Address - Country:US
Mailing Address - Phone:718-998-0291
Mailing Address - Fax:718-998-2236
Practice Address - Street 1:2276 E 1ST ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-5144
Practice Address - Country:US
Practice Address - Phone:718-998-0291
Practice Address - Fax:718-998-2236
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator