Provider Demographics
NPI:1629058706
Name:BATIKOV, ALEKSANDR (MD)
Entity Type:Individual
Prefix:
First Name:ALEKSANDR
Middle Name:
Last Name:BATIKOV
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 1:1668 W 6TH ST
Mailing Address - Street 2:APT 8B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223
Mailing Address - Country:US
Mailing Address - Phone:917-214-5581
Mailing Address - Fax:
Practice Address - Street 1:1668 W 6TH ST
Practice Address - Street 2:APT 8B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223
Practice Address - Country:US
Practice Address - Phone:917-214-5581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225474207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02351357Medicaid
NY62S631Medicare ID - Type Unspecified
NY02351357Medicaid