Provider Demographics
NPI:1215629043
Name:KAYKOVA, BELLA (FNP)
Entity type:Individual
Prefix:
First Name:BELLA
Middle Name:
Last Name:KAYKOVA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6321 BOELSEN CRES
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3949
Mailing Address - Country:US
Mailing Address - Phone:347-554-3172
Mailing Address - Fax:
Practice Address - Street 1:3508 JUNCTION BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11368-1743
Practice Address - Country:US
Practice Address - Phone:917-832-6999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY723595-01163W00000X
NYF34737201363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily