Provider Demographics
NPI:1003861022
Name:BAKCHEVA, VIKTORIYA (DO)
Entity Type:Individual
Prefix:
First Name:VIKTORIYA
Middle Name:
Last Name:BAKCHEVA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1599 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-4957
Mailing Address - Country:US
Mailing Address - Phone:718-360-5014
Mailing Address - Fax:718-360-2314
Practice Address - Street 1:1599 WEST 6 STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-4957
Practice Address - Country:US
Practice Address - Phone:718-360-5014
Practice Address - Fax:718-360-2314
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231341207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI04924Medicare UPIN