Individual
FREDA BORUKHOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14905 79TH AVE APT 623, FLUSHING, NY 11367-3832
(347) 893-6487
Mailing address
14905 79TH AVE APT 623, FLUSHING, NY 11367-3832
(347) 893-6487
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0166541
NY
Other
Enumeration date
08/27/2013
Last updated
08/27/2013
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