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Alisa Khomutova
Student in an Organized Health Care Education/Training Program in Stony Brook, New York
NPI 1659908960

Alisa Khomutova is a Student in an Organized Health Care Education/Training Program based in Stony Brook, NY. Alisa Khomutova practices in Stony Brook, NY. The NPI Number for Alisa Khomutova is 1659908960 and holds a License No. (New York).

The current practice location address for Alisa Khomutova is Hsc Level 19 Room 030, Stony Brook, NY and can be reached out via phone at 631-444-1791.

Location: Hsc Level 19 Room 030, Stony Brook, NY, 11794-0001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659908960
Provider Name
Alisa Khomutova
Credential
Provider Entity Type
Individual
Gender
Female
Address
Hsc Level 19 Room 030, Stony Brook, NY, 11794-0001
Phone Number
631-444-1791
Fax Number
Provider Enumeration Date
03/25/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
Hsc Level 19 Room 030
City
Stony Brook
State
New York
Zip
11794-0001
Phone Number
631-444-1791
Fax Number
person
Provider Business Mailing Address Details
Address
Hsc Level 19 Room 030
City
Stony Brook
State
New York
Zip
11794-0001
Phone Number
631-444-1791
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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