MEDICARE: DAVID KAYKOV

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	156FX1800X	Optician	008047-1	NY

General Provider Information

NPI Number	:	1750796017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID KAYKOV

Provider Business Mailing Address
First Line	:	2105 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3609
Country	:	US
Telephone Number	:	718-377-8898
Fax Number	:	718-891-2026

Provider Business Practice Location Address
First Line	:	2105 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3609
Country	:	US
Telephone Number	:	718-377-8898
Fax Number	:	718-891-2026

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

Provider Enumeration Date	:	06/25/2014
Last Update Date	:	06/25/2014

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Directions to “ DAVID KAYKOV ” Practice Location

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