Individual
CARL BORIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
99 GRAND AVE, MASSAPEQUA, NY 11758-1203
(516) 541-9700
(516) 798-1086
Mailing address
99 GRAND AVE, MASSAPEQUA, NY 11758-1203
(516) 795-2626
(516) 799-7451
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
089458
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00404884
—
NY
01
—
089458
HIP
—
01
—
201285536
EMPIRE
—
01
—
4115108
AETNA
—
01
—
5061
VYTRA
—
01
—
5491B1
BLUE CROSS BLUE SHIELD
—
01
—
5996232
GHI
—
01
—
5C4402
HEALTH NET
—
01
—
785722
CIGNA
—
01
—
AP624
OXFORD
—
01
—
P00230863
RR MCR
—
Enumeration date
12/05/2006
Last updated
05/19/2008
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