Healthcare Provider Details

I. General information

NPI: 1265594915
Provider Name (Legal Business Name): JUANA TOPOROVSKY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 BAINBRIDGE AVE #S5 JUANA TOPOROVSKY MD
BRONX NY
10467-1409
US

IV. Provider business mailing address

3510 BAINBRIDGE AVE #S5
BRONX NY
10467-1409
US

V. Phone/Fax

Practice location:
  • Phone: 718-655-4489
  • Fax:
Mailing address:
  • Phone: 718-655-4489
  • Fax: 718-405-5981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number094074
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: