Provider Demographics
NPI:1881120954
Name:BACH, IVO (MD)
Entity type:Individual
Prefix:DR
First Name:IVO
Middle Name:
Last Name:BACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:IVO
Other - Middle Name:
Other - Last Name:BACH-BACHICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:122 MAPLE AVE # 837
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4706
Mailing Address - Country:US
Mailing Address - Phone:914-849-5300
Mailing Address - Fax:
Practice Address - Street 1:122 MAPLE AVE FL 8
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4706
Practice Address - Country:US
Practice Address - Phone:914-849-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33118412084N0400X, 2084V0102X
NJ25MA112042002084N0400X, 2084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology