Individual
BORIS S PUGACHEVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1 BAY CLUB DR, APT.14-O, BAYSIDE, NY 11360-2915
(917) 604-5403
Mailing address
1 BAY CLUB DR, APT.14-O, BAYSIDE, NY 11360-2915
(917) 604-5403
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
022292
NY
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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