Provider Demographics
NPI:1851483473
Name:BACH-BACHICH, VJERA (MD)
Entity Type:Individual
Prefix:DR
First Name:VJERA
Middle Name:
Last Name:BACH-BACHICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VJERA
Other - Middle Name:
Other - Last Name:BACH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1650 SELWYN AVE
Mailing Address - Street 2:6D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7626
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1650 SELWYN AVE
Practice Address - Street 2:6D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7626
Practice Address - Country:US
Practice Address - Phone:718-960-1409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1829302080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01719722Medicare ID - Type Unspecified