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General NPI Number Information
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NPI Number | 1144356247
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Entity Type | Individual
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Provider Name | BORIS KATAYEV DDS
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 130 GARTH RD
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City | SCARSDALE
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State | NY
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Zip | 10583-3750
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Country | US
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Telephone | 914-472-1555
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Fax | 914-472-0399
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Provider Business Mailing Address
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Address Line | 108 48 59TH AVENUE
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City | FOREST HILLS
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State | NY
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Zip | 11375
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Country | US
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Telephone | 718-897-0581
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 048857-1
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License Number State | NY
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