Doctor Name: | DR. VALERIY BAYSHTOK |
NPI Number: | 1063447878 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 157463 |
Business Practice Address: | 6536 99th St Rego Park, NY - 113744358 |
Business Phone Number: | 7188965219 |
Business Fax Number: | |
Mailing Address: | 65-36 99th Street, REGO PARK |
State: | NY |
Postal Code: | 11374 |
Phone Number: | 7188965219 |
Fax Number: | |
NPI Enumeration Date: | 07/11/2006 |
NPI Last Update Date: | 04/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0000X |
License Number: | 157463 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adolescent Medicine |
Taxonomy Definition: | A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |