Provider Demographics
NPI:1154853331
Name:BYCHOK, DMITRIY (DO)
Entity Type:Individual
Prefix:DR
First Name:DMITRIY
Middle Name:
Last Name:BYCHOK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 ANTOINETTE DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-2164
Mailing Address - Country:US
Mailing Address - Phone:347-301-4313
Mailing Address - Fax:
Practice Address - Street 1:66 W GILBERT ST STE 100
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07701-4948
Practice Address - Country:US
Practice Address - Phone:732-212-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB10987200207L00000X
NY297832207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty