Boris Itskovich, MD

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

207492 Issued in NY

Legal business name

BORIS ITSKOVICH, MD

Practice address

3009 Ocean Pkwy
Brooklyn, NY 11235-8302

Phone

(718) 373-0777

Fax

(718) 373-8454

NPI assigned

Jul 29, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Boris Itskovich, M.D.NPI 1235197252

Title

President

Phone

(718) 373-0777

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Boris Itskovich, M.D

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1235197252
  NPD (past) Authorized official
• Chaim Shtock

  • Specialist
  • Brooklyn, NY
  • NPI 1902872963
  NPD (past)

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375056000000",
    "number": "1164864369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358302",
            "telephone_number": "718-373-0777",
            "fax_number": "718-373-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358302",
            "telephone_number": "718-373-0777",
            "fax_number": "718-373-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORIS ITSKOVICH, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-29",
        "last_updated": "2013-07-29",
        "status": "A",
        "authorized_official_last_name": "ITSKOVICH",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-373-0777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "207492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01799137",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Panid Borhanjoo, MD
• Taisiya Borik, M.A.
• Olga Borinski
• Boris Bobyr NP in Adult Health PC
• Boris Dudelzak DO PC
• Boris Ovodenko MD PC
• Boris Sagalovich, MD PC
• Boris Tsemekhin Anesthesia PC
• Boris Yaguda Medical PC
• Melanie D Borisoff, PH.D.

• Primary Care Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.