Provider Demographics
NPI:1265594915
Name:TOPOROVSKY, JUANA (MD)
Entity type:Individual
Prefix:DR
First Name:JUANA
Middle Name:
Last Name:TOPOROVSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 BAINBRIDGE AVE
Mailing Address - Street 2:#S5
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-1409
Mailing Address - Country:US
Mailing Address - Phone:718-655-4489
Mailing Address - Fax:718-405-5981
Practice Address - Street 1:3510 BAINBRIDGE AVE #S5
Practice Address - Street 2:JUANA TOPOROVSKY MD
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-1409
Practice Address - Country:US
Practice Address - Phone:718-655-4489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094074208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00154494Medicaid
NY00154494Medicaid