Konnikow, Boris A
Konnikow, Boris A is an sole proprietor health care provider with primary practice located at 11020 71St Rd Suite 104, Forest Hills NY 11375-4945. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Konnikow, Boris A can be contacted via phone (718) 263-3355.Contact Information
Primary practice address
11020 71St Rd Suite 104
Forest Hills NY 11375-4945
Phone: (718) 263-3355
Fax: (718) 263-3373
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 204106 | New York |
Profile Details
| NPI number | 1841281540 |
|---|---|
| LBN Legal business name | Konnikow, Boris A |
| Credentials | MD PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Aug 14th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841281540 | NPPES |
| New York | MEDICAID | 02101206 |
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