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General NPI Number Information
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NPI Number | 1316059462
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Entity Type | Individual
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Provider Name | BORIS NEMIROVSKY MD
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 9892 BUSTLETON AVE STE 206
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City | PHILADELPHIA
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State | PA
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Zip | 19115-2139
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Country | US
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Telephone | 215-698-2220
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Fax | 215-464-1808
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Provider Business Mailing Address
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Address Line | PO BOX 52036
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City | PHILADELPHIA
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State | PA
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Zip | 19115-7036
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Country | US
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Telephone | 215-698-2220
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Fax | 215-464-1808
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 032418E
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License Number State | PA
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