Provider Demographics
NPI:1710300165
Name:AMERIWOUND PHYSICIANS NY PLLC
Entity Type:Organization
Organization Name:AMERIWOUND PHYSICIANS NY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BORISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-273-9800
Mailing Address - Street 1:5800 LANDERBROOK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-6510
Mailing Address - Country:US
Mailing Address - Phone:216-273-9800
Mailing Address - Fax:440-461-1225
Practice Address - Street 1:71-10 PARK AVE
Practice Address - Street 2:APT 5P
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-4106
Practice Address - Country:US
Practice Address - Phone:216-273-9800
Practice Address - Fax:440-461-1225
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERIWOUND PHYSICIANS NY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-21
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty