Provider Demographics
NPI:1881728889
Name:YEVGENIYA KAYKOVA MEDICAL, PC
Entity type:Organization
Organization Name:YEVGENIYA KAYKOVA MEDICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YEVGENIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAYKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-213-0800
Mailing Address - Street 1:132 DOVER ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3720
Mailing Address - Country:US
Mailing Address - Phone:212-213-0800
Mailing Address - Fax:212-481-4014
Practice Address - Street 1:251 E 33RD ST
Practice Address - Street 2:SUITE 1N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4804
Practice Address - Country:US
Practice Address - Phone:212-213-0800
Practice Address - Fax:212-481-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199871207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEK322Medicare ID - Type Unspecified