MEDICARE: YOAV BORSUK MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	213551-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	213551-1	OTHER	NY	LICENSE NUMBER

General Provider Information

NPI Number	:	1093008278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOAV BORSUK MD PC

Provider Business Mailing Address
First Line	:	167 MADISON AVE
Second Line	:	SUITE # 605
City	:	NEW YORK
State	:	NY
Zip	:	10016-5430
Country	:	US
Telephone Number	:	212-979-8880
Fax Number	:

Provider Business Practice Location Address
First Line	:	167 MADISON AVE
Second Line	:	SUITE # 605
City	:	NEW YORK
State	:	NY
Zip	:	10016-5430
Country	:	US
Telephone Number	:	212-979-8880
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. YOAV BORSUK
Credential	:	M.D.
Telephone Number	:	917-509-0222

Provider Enumeration Date	:	05/23/2011
Last Update Date	:	10/03/2012

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