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General NPI Number Information
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NPI Number | 1083005797
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Entity Type | Organization
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Legal Business Name | FOREST HILLS AUDIOLOGY PC
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Dates
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Enumeration Date | 02/17/2015
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Last Update Date | 02/10/2016
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Provider Practice Location Address
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Address Line | 11011 72ND AVE STE 1B
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City | FOREST HILLS
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State | NY
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Zip | 11375-4910
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Country | US
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Telephone | 718-577-2235
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Fax | 347-229-9000
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Provider Business Mailing Address
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Address Line | 11011 72ND AVE STE 1B
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City | FOREST HILLS
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State | NY
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Zip | 11375-4910
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Country | US
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Telephone | 718-577-2235
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Fax | 347-229-9000
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Authorized Official
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Title or Position | ADIOLOGIST/OWNER
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Name | DR. ROKSANA BORUKHOVA
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Credential | AU.D
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Telephone | 347-409-8958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 002511-1
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License Number State | NY
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