Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 231341 | NY |
NPI | 1003861022 |
---|---|
Provider Name | Viktoriya Bakcheva |
First Address | Brooklyn, NY 11204-4957 |
Second Address | Brooklyn, NY 11204-4957 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 12/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I04924 | (02) | NY |