Provider Demographics
NPI:1003815432
Name:TRAYKOVSKI, GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:TRAYKOVSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 CENTRAL PARK W APT 9F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5205
Mailing Address - Country:US
Mailing Address - Phone:212-877-2016
Mailing Address - Fax:212-877-5609
Practice Address - Street 1:80 CENTRAL PARK W APT 9F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5205
Practice Address - Country:US
Practice Address - Phone:212-877-2016
Practice Address - Fax:212-877-5609
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2011-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY125331207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00234675Medicaid
NY00234675Medicaid
NY0154050001Medicare NSC
NY297961Medicare ID - Type Unspecified