Individual
IVAN BORAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 PELHAM PKWY S, BRONX, NY 10461-1138
(718) 918-5000
Mailing address
332 E 67TH ST, NEW YORK, NY 10065-6231
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
113738
ZZ
Other
Enumeration date
06/25/2018
Last updated
06/25/2018
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