B Konnikow Physician PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

204106 Issued in NY

Legal business name

B KONNIKOW PHYSICIAN PC

Practice address

11020 71St Rd
#104
Forest Hills, NY 11375-4945

Phone

(718) 263-3355

Fax

(718) 263-3373

NPI assigned

Apr 11, 2008

Last updated

Apr 14, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Boris A Konnikow, M.D.NPI 1841281540

Title

President

Phone

(718) 263-3355

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Boris A Konnikow, MD PHD

  • Psychiatry Physician
  • Forest Hills, NY
  • NPI 1841281540
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1083887913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7636 113TH ST",
            "address_2": "5B",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756513",
            "telephone_number": "718-263-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11020 71ST RD",
            "address_2": "#104",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754945",
            "telephone_number": "718-263-3355",
            "fax_number": "718-263-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B KONNIKOW PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "KONNIKOW",
        "authorized_official_first_name": "BORIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-263-3355",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "204106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seda Ayata, LMHC
• Rosalia Ayuso, MD, PHD
• Tanesh Kumar Ayyalu, MD
• Edwin Cohen Azarkian, MD
• Ugonna Robert Azode, MD
• B Rubin Inc.
• Sofya Bababekova, FNP-C
• Aleksey Babakhanov, FNP
• Zarrina Babakhanova
• Joshua Lazer Babayev, PHARMD

• Psychiatry Physician in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.