MEDICARE: DR. BORIS DUBROVSKY PHD,CBSM,DBSM,RPSGT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	018170	NY
2	246Z00000X	Other Specialist/Technologist	11039	NY

General Provider Information

NPI Number	:	1194955526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BORIS DUBROVSKY PHD,CBSM,DBSM,RPSGT

Provider Business Mailing Address
First Line	:	509 6TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-3675
Country	:	US
Telephone Number	:	718-780-3017
Fax Number	:	718-780-6711

Provider Business Practice Location Address
First Line	:	519 6TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-3608
Country	:	US
Telephone Number	:	718-780-3017
Fax Number	:	718-780-6711

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2009
Last Update Date	:	07/29/2024

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Directions to “ DR. BORIS DUBROVSKY PHD,CBSM,DBSM,RPSGT” Practice Location

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