Provider Demographics
NPI:1164553756
Name:ZUSIN, BORIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:BORIS
Middle Name:
Last Name:ZUSIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 W END AVE
Mailing Address - Street 2:SUITE 1-G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5539
Mailing Address - Country:US
Mailing Address - Phone:212-877-7475
Mailing Address - Fax:212-877-7591
Practice Address - Street 1:185 W END AVE
Practice Address - Street 2:SUITE 1-G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5539
Practice Address - Country:US
Practice Address - Phone:212-877-7475
Practice Address - Fax:212-877-7591
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046022122300000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies