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General NPI Number Information
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NPI Number | 1952708836
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Entity Type | Individual
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Provider Name | BORIS BENJAMIN BERNADSKY L.M.T. L.AC.
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Gender | Male
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Dates
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Enumeration Date | 11/20/2014
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Last Update Date | 09/25/2015
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Provider Practice Location Address
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Address Line | 40 EXCHANGE PL 3RD FLOOR
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City | NEW YORK
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State | NY
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Zip | 10005-2701
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Country | US
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Telephone | 732-331-0925
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Fax |
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Provider Business Mailing Address
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Address Line | 1368 BAY RIDGE AVE APT 3
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City | BROOKLYN
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State | NY
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Zip | 11219-6116
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Country | US
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Telephone | 732-331-0925
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 27 027747
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25 005638
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License Number State | NY
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