Individual
BORIS MARKOVICH PETRIKOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2201 HEMPSTEAD TPKE, MEDICAL STAFF OFFICE BOX 42, EAST MEADOW, NY 11554
(516) 572-6255
(516) 572-3124
Mailing address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
(516) 572-6255
(516) 572-3124
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
163782
NY
207VX0000X
Obstetrics Physician
163782-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01087425
—
NY
Enumeration date
03/01/2006
Last updated
09/04/2018
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