MEDICARE: DR. LEONARD BAKALCHUK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	187449	NY
2	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	187449	NY

General Provider Information

NPI Number	:	1699792531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONARD BAKALCHUK M.D.

Provider Business Mailing Address
First Line	:	440 KENT AVE APT 5D
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11249-5928
Country	:	US
Telephone Number	:	646-286-1213
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 E 42ND ST FL 7
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-5835
Country	:	US
Telephone Number	:	212-609-1920
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	04/01/2024

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