Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 093363 | NY |
NPI | 1023179108 |
---|---|
Provider Name | Dr. Alexander Traykovski |
First Address | Bronx, NY 10457-7606 |
Second Address | Bronx, NY 10457-7606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 01/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00152194 | (05) | NY |
D12039 | (02) | NY |