Provider Demographics
NPI:1780902197
Name:KHAYKOV, NATALIYA (RPH)
Entity type:Individual
Prefix:MS
First Name:NATALIYA
Middle Name:
Last Name:KHAYKOV
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 HOLMES LN
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2814
Mailing Address - Country:US
Mailing Address - Phone:973-460-7532
Mailing Address - Fax:
Practice Address - Street 1:425 OLD HOOK RD
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1323
Practice Address - Country:US
Practice Address - Phone:201-262-1722
Practice Address - Fax:201-262-4212
Is Sole Proprietor?:No
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049958-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist