Individual
BORIS N FATAKHOV
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
606 WINTHROP ST, 6 BUILDING, BROOKLYN, NY 11203-1709
(718) 245-2362
Mailing address
7111 YELLOWSTONE BLVD, APT 2P, FOREST HILLS, NY 11375-3541
(718) 575-1547
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
231567
NY
Other
Enumeration date
01/04/2006
Last updated
07/08/2007
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