Provider Demographics
NPI:1861821183
Name:BEK, VIKTOR
Entity Type:Individual
Prefix:
First Name:VIKTOR
Middle Name:
Last Name:BEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 STATE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-1304
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 STATE RD
Practice Address - Street 2:SUITE B
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1304
Practice Address - Country:US
Practice Address - Phone:732-766-1869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013730225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist