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General NPI Number Information
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NPI Number | 1053167692
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Entity Type | Organization
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Legal Business Name | OLEG BAZYLKO ACUPUNCTURE PC
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Dates
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Enumeration Date | 04/25/2024
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 3364 NOSTRAND AVE
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City | BROOKLYN
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State | NY
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Zip | 11229-4004
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Country | US
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Telephone | 917-279-6405
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Fax |
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Provider Business Mailing Address
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Address Line | 501 SURF AVE APT 3L
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City | BROOKLYN
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State | NY
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Zip | 11224-3559
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | OLEG BAZYLKO
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Credential |
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Telephone | 929-924-6024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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