Healthcare Provider Details

I. General information

NPI: 1689221830
Provider Name (Legal Business Name): BORIS KARACHUN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2019
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1144 PELHAM PKWY S OFC A
BRONX NY
10461-1013
US

IV. Provider business mailing address

1144 PELHAM PKWY S OFC A
BRONX NY
10461-1013
US

V. Phone/Fax

Practice location:
  • Phone: 718-822-6896
  • Fax: 718-597-8462
Mailing address:
  • Phone: 718-822-6896
  • Fax: 718-597-8462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number062336
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: