Provider Demographics
NPI:1477562494
Name:ZARETSKY, BORIS (DPT)
Entity Type:Individual
Prefix:DR
First Name:BORIS
Middle Name:
Last Name:ZARETSKY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 W 38TH ST
Mailing Address - Street 2:RM 503
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-6368
Mailing Address - Country:US
Mailing Address - Phone:917-442-7763
Mailing Address - Fax:
Practice Address - Street 1:3065 BRIGHTON 14TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5501
Practice Address - Country:US
Practice Address - Phone:718-646-8700
Practice Address - Fax:718-646-8726
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018570225100000X
NJ40QA00981600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQQ6231Medicare ID - Type Unspecified