Individual
DR. SVYATOSLAV BAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
745 64TH ST, BROOKLYN, NY 11220-4753
(718) 283-1913
(718) 635-6745
Mailing address
355 MALLORY AVE, B, STATEN ISLAND, NY 10305-4200
(718) 876-6226
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
052698-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
052698-1
LCSW
NY
Enumeration date
05/01/2007
Last updated
07/08/2007
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