Provider Demographics
NPI:1376645085
Name:HRINCZENKO, BORYS W (MD)
Entity Type:Individual
Prefix:
First Name:BORYS
Middle Name:W
Last Name:HRINCZENKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 GREENLAWN AVE
Mailing Address - Street 2:MSU BRESLIN CANCER CLINIC
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910
Mailing Address - Country:US
Mailing Address - Phone:517-975-9500
Mailing Address - Fax:517-975-9511
Practice Address - Street 1:804 SERVICE RD # A201
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-7015
Practice Address - Country:US
Practice Address - Phone:517-884-2976
Practice Address - Fax:517-432-3928
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2016-07-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35084578207RH0000X, 207RX0202X
MI4301095411207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1376645085Medicaid
OH2482808Medicaid
MI1376645085Medicaid
MIC36082122Medicare PIN
OHF59918Medicare UPIN