Individual
BOGDAN BAKALOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
92-11 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-7857
(718) 651-0300
(718) 639-5513
Mailing address
2113 E 38TH, BROOKLYN, NY 11234-4929
(718) 377-2838
(718) 377-5952
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
153329
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00763337
—
NY
Enumeration date
05/16/2007
Last updated
07/08/2007
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