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NPI Code Detail

MEDICARE: DR. BORIS SACHAKOV MD

MEDICARE: DR. BORIS SACHAKOV MD
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
1208C00000XColon & Rectal Surgery Physician228151NY

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 : 1376524785
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BORIS SACHAKOV MD
Provider Business Mailing Address
First Line : 6610 YELLOWSTONE BLVD
Second Line : APT 4D
City : FOREST HILLS
State : NY
Zip : 11375-2042
Country : US
Telephone Number : 719-896-5662
Fax Number : 718-621-1365
Provider Business Practice Location Address
First Line : 8405 BAY PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-3359
Country : US
Telephone Number : 718-621-1800
Fax Number : 718-621-1365
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2005
Last Update Date : 03/31/2010

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