Boris Mordkovich MD Plastic Surgery, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA08107700 Issued in NJ

Legal business name

BORIS MORDKOVICH MD PLASTIC SURGERY, PC

Practice address

96 Linwood PLZ # 307
Fort Lee, NJ 07024-3701

Phone

(201) 751-9490

Fax

(908) 730-0001

NPI assigned

Jun 22, 2009

Last updated

Jun 22, 2009By 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

Dr. Boris Mordkovich, MDNPI 1992915490

Title

Owner

Phone

(201) 751-9490

Specialties & licenses 1

Addresses

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 Mordkovich, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Englewood Cliffs, NJ
  • NPI 1992915490
  Authorized official Same address or phone

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245628800000",
    "number": "1841427499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 LINWOOD PLZ # 307",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070243701",
            "telephone_number": "201-751-9490",
            "fax_number": "908-730-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 LINWOOD PLZ # 307",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070243701",
            "telephone_number": "201-751-9490",
            "fax_number": "908-730-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORIS MORDKOVICH MD PLASTIC SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-22",
        "last_updated": "2009-06-22",
        "status": "A",
        "authorized_official_last_name": "MORDKOVICH",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-751-9490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA08107700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raquel Blaya
• Board Certified Orthopedic Surgical Specilists LLC
• Svetlana Bodneva, D.D.S.,
• Candace Ann Boltuch-Fagan, LPC;LCADC
• Anup Borawala
• Borough of Fort Lee
• Borough of Fort Lee
• Michelle L Botsacos, OD
• Juanita Latrelle Boyd
• Dinah Joan Braude Kremberg, PHD

• Specialist in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.