Provider Demographics
NPI:1457352502
Name:RAGINSKY, BORIS (DPM)
Entity Type:Individual
Prefix:DR
First Name:BORIS
Middle Name:
Last Name:RAGINSKY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 CRANBURY RD
Mailing Address - Street 2:STE. 106
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4000
Mailing Address - Country:US
Mailing Address - Phone:732-698-2444
Mailing Address - Fax:732-698-9844
Practice Address - Street 1:620 CRANBURY RD
Practice Address - Street 2:STE. 106
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4000
Practice Address - Country:US
Practice Address - Phone:732-698-2444
Practice Address - Fax:732-698-9844
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD2554213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8024901Medicaid
NJ030997L00Medicare PIN
NJU76696Medicare UPIN