Individual
DR. BORIS MASHALOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 PELHAM PKWY S, BRONX, NY 10461
(718) 918-3060
(718) 918-4469
Mailing address
3424 KOSSUTH AVE, BRONX, NY 10467-2410
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
221465
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02184187
—
NY
Enumeration date
10/11/2006
Last updated
05/25/2018
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