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General NPI Number Information
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NPI Number | 1457749392
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Entity Type | Individual
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Provider Name | ROKSANA BORUKHOVA AU.D.
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Gender | Female
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Dates
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Enumeration Date | 12/30/2014
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Last Update Date | 12/30/2014
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Provider Practice Location Address
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Address Line | 11011 72ND AVE 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 | 718-261-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 8002 21 AVENUE 3H
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City | BROOKLYN
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State | NY
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Zip | 11214
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Country | US
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Telephone | 347-409-8958
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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 | 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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