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General NPI Number Information
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NPI Number | 1184847246
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Entity Type | Organization
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Legal Business Name | BORIS KHARITON MD PC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 70 JUNGERMANN CIR STE 302
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City | SAINT PETERS
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State | MO
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Zip | 63376-1637
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Country | US
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Telephone | 314-667-5535
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Fax | 314-261-5010
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Provider Business Mailing Address
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Address Line | PO BOX 411091
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City | SAINT LOUIS
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State | MO
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Zip | 63141-3091
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Country | US
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Telephone | 314-667-5535
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Fax | 314-261-5010
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. JOELLEN HARTZELL
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Credential |
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Telephone | 314-667-5535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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