Healthcare Provider Details

I. General information

NPI: 1780472357
Provider Name (Legal Business Name): KRISTEN BACHOO DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 04/25/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 7TH AVE FL 14
NEW YORK NY
10018-4603
US

IV. Provider business mailing address

162A UTICA AVE
BROOKLYN NY
11213-2369
US

V. Phone/Fax

Practice location:
  • Phone: 212-768-7979
  • Fax:
Mailing address:
  • Phone: 315-800-9210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number013951
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: