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NPI Code Detail

MEDICARE: BORIS KOMROVSKY M.D.

MEDICARE: BORIS KOMROVSKY M.D.
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
1174400000XSpecialist35045106KOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336183607
Entity Type Code : Individual
Provider Name (Legal Business Name) : BORIS KOMROVSKY M.D.
Provider Business Mailing Address
First Line : 7003 PEARL RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44130-4941
Country : US
Telephone Number : 440-888-2333
Fax Number : 440-888-2335
Provider Business Practice Location Address
First Line : 7003 PEARL RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44130-4941
Country : US
Telephone Number : 440-888-2333
Fax Number : 440-888-2335
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2006
Last Update Date : 08/07/2012

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Directions to “ BORIS KOMROVSKY M.D.” Practice Location

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