Individual
BORIS MATUSEVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1175 MONTAUK HWY, SUITE 1, WEST ISLIP, NY 11795-4939
(631) 321-0570
Mailing address
941 BETH LN, WOODMERE, NY 11598-1544
(516) 374-6326
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
217094-1
NY
Other
Enumeration date
03/10/2006
Last updated
03/03/2008
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