Individual
BACHOR SIYVNOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2015 GRAND CONCOURSE, BRONX, NY 10453-4303
(718) 299-7295
Mailing address
2015 GRAND CONCOURSE, BRONX, NY 10453-4303
(718) 299-7295
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
020451
NY
363A00000X
Physician Assistant
—
—
Other
Enumeration date
10/07/2016
Last updated
10/27/2020
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