Provider Demographics
NPI:1255621934
Name:VORIK, BORIS (DPT)
Entity type:Individual
Prefix:
First Name:BORIS
Middle Name:
Last Name:VORIK
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 1:1230 AVENUE Y
Mailing Address - Street 2:SUITE E19
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4271
Mailing Address - Country:US
Mailing Address - Phone:917-476-2884
Mailing Address - Fax:
Practice Address - Street 1:1230 AVENUE Y
Practice Address - Street 2:SUITE E19
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4271
Practice Address - Country:US
Practice Address - Phone:917-476-2884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-14
Last Update Date:2013-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033278225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist