| Boris Itskovich, Md | |
|
3009 Ocean Pkwy Brooklyn NY 11235-8302 | |
| (718) 373-0777 | |
| (718) 373-8454 |
| Full Name | Boris Itskovich, Md |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3009 Ocean Pkwy, Brooklyn, New York |
| Authorized Official Name and Position | Boris Itskovich (PRESIDENT) |
| Authorized Official Contact | 7183730777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boris Itskovich, Md 3009 Ocean Pkwy Brooklyn NY 11235-8302 Ph: (718) 373-0777 | Boris Itskovich, Md 3009 Ocean Pkwy Brooklyn NY 11235-8302 Ph: (718) 373-0777 |
| NPI Number | 1164864369 |
|---|---|
| Provider Enumeration Date | 07/29/2013 |
| Last Update Date | 07/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164864369 | NPI | - | NPPES |
| 01799137 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 207492 (New York) | Primary |
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