Provider Demographics
NPI:1881786184
Name:SHEINKERMAN, BORIS Z (MD)
Entity type:Individual
Prefix:DR
First Name:BORIS
Middle Name:Z
Last Name:SHEINKERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-8400
Mailing Address - Country:US
Mailing Address - Phone:862-249-1333
Mailing Address - Fax:844-892-1555
Practice Address - Street 1:8340 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7824
Practice Address - Country:US
Practice Address - Phone:718-441-4444
Practice Address - Fax:718-849-7854
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173254207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01050453Medicaid
NY05726Medicare ID - Type UnspecifiedGHI
NYB17103Medicare UPIN
NY61D401Medicare ID - Type UnspecifiedEMPIRE BC/BS