Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 238669 | NY |
NPI | 1609821297 |
---|---|
Provider Name | Dr. Boris Chernobilsky |
First Address | New York, NY 10016-2708 |
Second Address | New York, NY 10016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 08/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03233401 | (05) | NY |