Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 25MA10009400 | NJ |
NPI | 1952691834 |
---|---|
Provider Name | Dr. Boris Paskhover |
First Address | Newark, NJ 07103-2545 |
Second Address | Newark, NJ 07103-2425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2011 |
Last Update Date | 12/07/2017 |