Provider Demographics
NPI:1265836134
Name:KACHKO, ROBERT (ND LAC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:KACHKO
Suffix:
Gender:M
Credentials:ND LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 COURT ST STE B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6592
Mailing Address - Country:US
Mailing Address - Phone:718-866-3695
Mailing Address - Fax:
Practice Address - Street 1:239 COURT ST STE B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-6592
Practice Address - Country:US
Practice Address - Phone:718-866-3695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005514171100000X
175F00000X
CT525175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist