Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | NY125331 | NY |
NPI | 1003815432 |
---|---|
Provider Name | George Traykovski |
First Address | New York, NY 10023-5205 |
Second Address | New York, NY 10023-5205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 28/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00234675 | (05) | NY |
B12484 | (02) | NY |