Individual
EKATERINE BACHILAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
336 E 86TH ST, NEW YORK, NY 10028-4615
(212) 933-1364
Mailing address
1345 RXR PLZ FL 13, UNIONDALE, NY 11556-1301
(516) 783-4600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
021932
NY
Other
Enumeration date
11/15/2018
Last updated
01/16/2019
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