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General NPI Number Information
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NPI Number | 1982290557
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Entity Type | Individual
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Provider Name | BORIS TEMKIN
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Gender | Male
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Dates
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Enumeration Date | 12/17/2020
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 6500 CREEDMOOR RD STE 110
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City | RALEIGH
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State | NC
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Zip | 27613-3698
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Country | US
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Telephone | 919-825-4000
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Fax | 919-846-7255
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Provider Business Mailing Address
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Address Line | 304 GENESEE ST
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City | CHITTENANGO
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State | NY
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Zip | 13037-1707
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Country | US
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Telephone | 315-687-6467
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 027709
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0010-14229
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-14229
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License Number State | NC
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