Individual
DR. BORIS L PRAKHINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
33-00 BROADWAY, SUITE # 209, FAIR LAWN, NJ 07410-4617
(201) 796-7666
(201) 796-5570
Mailing address
33-00 BROADWAY, SUITE # 209, FAIR LAWN, NJ 07410-4617
(201) 796-7666
(201) 796-5570
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA068923
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7979100
—
NJ
Enumeration date
05/24/2007
Last updated
08/10/2012
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