1821078882 NPI number — GENESIS ANESTHESIA SERVICES, PSC

Table of content: DR. VICTOR PETROVICH BOCHKAREV M.D. (NPI 1649390550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821078882 NPI number — GENESIS ANESTHESIA SERVICES, PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GENESIS ANESTHESIA SERVICES, PSC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821078882
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6450
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00681-6450
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-805-1818
Provider Business Mailing Address Fax Number:
787-832-1585

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HOSPITAL BELLA VISTA CARR 349 KM 2.7 CERRO LAS MESAS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-805-1818
Provider Business Practice Location Address Fax Number:
787-832-1585
Provider Enumeration Date:
01/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BAYRON-VELEZ
Authorized Official First Name:
ROBERTO
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
787-805-1818

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9242 . This is a "FIRST MEDICAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "HARVARD PILGRIM HEALTH CA" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "ADVENTISTS RISK MANAGEMEN" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "HUMANA GOLD CLASSIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 32516 . This is a "ASPCIACION DE MAESTROS DE" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "CHAMPUS/CHAMPVA" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "AETNA INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "CIGNA HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1696 . This is a "AMERICAN HEALTH INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61101 . This is a "HUMANA GOLD CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6810035 . This is a "HUMANA INSURANCE OF PR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6810035 . This is a "HUMANA HEALTH OF PUERTO R" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "AARP" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "FIRST PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "COSVI" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "CARE PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "AIG CLAIN SERVICES INC" identifier . This identifiers is of the category "OTHER".




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