Boter & Kozhin Obstetrical & Gynecological PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

139141 Issued in NY

Legal business name

BOTER & KOZHIN OBSTETRICAL & GYNECOLOGICAL PC

Practice address

6960 108TH St
Suite 101
Forest Hills, NY 11375-4323

Phone

(718) 275-8200

Fax

(718) 896-3166

NPI assigned

Jul 2, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Nodar Kozhin, MDNPI 1346325230

Title

Owner

Phone

(718) 275-8200

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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

• Nodar Kozhin, MD

  • Obstetrics & Gynecology Physician
  • Forest Hills, NY
  • NPI 1346325230
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1619130358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6960 108TH STREET",
            "address_2": "SUITE 101",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754323",
            "telephone_number": "718-275-8200",
            "fax_number": "718-896-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6960 108TH ST",
            "address_2": "SUITE 101",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754323",
            "telephone_number": "718-275-8200",
            "fax_number": "718-896-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOTER & KOZHIN OBSTETRICAL & GYNECOLOGICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "KOZHIN",
        "authorized_official_first_name": "NODAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-275-8200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "139141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1825167",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.