Provider Demographics
NPI:1750796017
Name:KAYKOV, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:KAYKOV
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 1:2105 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3609
Mailing Address - Country:US
Mailing Address - Phone:718-377-8898
Mailing Address - Fax:718-891-2026
Practice Address - Street 1:2105 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3609
Practice Address - Country:US
Practice Address - Phone:718-377-8898
Practice Address - Fax:718-891-2026
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008047-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician