MEDICARE: REGINA 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	183500000X	Pharmacist	067507	NY

General Provider Information

NPI Number	:	1891381299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINA KAYKOV

Provider Business Mailing Address
First Line	:	10540 62ND RD
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-1138
Country	:	US
Telephone Number	:	917-704-5384
Fax Number	:

Provider Business Practice Location Address
First Line	:	10540 62ND RD
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-1138
Country	:	US
Telephone Number	:	917-704-5384
Fax Number	:

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

Provider Enumeration Date	:	12/19/2020
Last Update Date	:	12/19/2020

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Directions to “ REGINA KAYKOV ” Practice Location

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