Provider Demographics
NPI:1023301728
Name:PINHASOV, BORIS (DDS)
Entity type:Individual
Prefix:DR
First Name:BORIS
Middle Name:
Last Name:PINHASOV
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 1:19 W 44TH ST STE 314
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-5900
Mailing Address - Country:US
Mailing Address - Phone:212-221-3999
Mailing Address - Fax:212-221-0399
Practice Address - Street 1:19 W 44TH ST STE 314
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-5900
Practice Address - Country:US
Practice Address - Phone:212-221-3999
Practice Address - Fax:212-221-0399
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-27
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010464122300000X
NY055906122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist