Basic Information
| Provider Information | |||||||||
| NPI: | 1871559906 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMARIS | ||||||||
| FirstName: | BORIS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1815 E 29TH ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112292518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185261000 | ||||||||
| FaxNumber: | 7182988531 | ||||||||
| Practice Location | |||||||||
| Address1: | 179TH STREET AND LINDEN BLVD | ||||||||
| Address2: | |||||||||
| City: | ST. ALBANS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114250001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185261000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 023118 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.