Stephen V Boris MD PC

Key facts

NPI

1013090729

Entity type

Organization (NPI type 2)

Primary specialty

Family Medicine Physician 207Q00000X

License

099770 (NY)

Legal business name

STEPHEN V BORIS MD PC

Practice address

895 Mamaroneck Avenue
Manaroneck, NY 10543

Phone

(914) 698-6666

Fax

(914) 698-6681

NPI assigned

Oct 24, 2006

Organization subpart

No

Authorized official

Name

Dr. Stephen V Boris, MD

Title

President

Phone

(914) 698-6666

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 11, 2025.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1013090729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 MAMARONECK AVE",
            "city": "MANARONECK",
            "state": "NY",
            "postal_code": "10543",
            "telephone_number": "914-698-6666",
            "fax_number": "914-698-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 MAMARONECK AVENUE",
            "city": "MANARONECK",
            "state": "NY",
            "postal_code": "10543",
            "telephone_number": "914-698-6666",
            "fax_number": "914-698-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN V BORIS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "BORIS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-698-6666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "099770",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "099770",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00443265",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}