Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 7525 | OH |
Y | 2251E1200X | Ergonomics | 7525 | OH |
Y | 225XE1200X | Ergonomics | 7525 | OH |
NPI | 1689619447 |
---|---|
Provider Name | Dr. Boris Pichkar |
First Address | Shaker Heights, OH 44122-5288 |
Second Address | Shaker Heights, OH 44122-5288 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 31/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2430926 | (05) | OH |
P93498 | (02) | OH |