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NPI Code Detail

MEDICARE: DR. BORIS PICHKAR PT, DPT

MEDICARE: DR. BORIS PICHKAR PT, DPT
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
1225100000XPhysical Therapist7525OH
22251E1200XErgonomics Physical Therapist7525OH

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 : 1689619447
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BORIS PICHKAR PT, DPT
Provider Business Mailing Address
First Line : 3570 WARRENSVILLE CENTER RD
Second Line : SUITE 102-D
City : SHAKER HEIGHTS
State : OH
Zip : 44122-5288
Country : US
Telephone Number : 440-580-0088
Fax Number : 440-580-0088
Provider Business Practice Location Address
First Line : 3570 WARRENSVILLE CENTER RD
Second Line : SUITE 102-D
City : SHAKER HEIGHTS
State : OH
Zip : 44122-5288
Country : US
Telephone Number : 440-580-0088
Fax Number : 440-580-0088
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2006
Last Update Date : 08/31/2016

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