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Export Provider Record NPI 1174057012
Moshe Michael BorohovPA
Active
NPI Number1174057012
NPI TypeNPI-1 Individual
SpecialtyPhysician Assistant, Medical
Provider Details
NPI1174057012
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2017-04-18
Last Updated2017-04-18
Mailing Address1520 Hornell Loop, Apt# 5f
Brooklyn, NY 11239
United States
Phone: (646) 322-2666
📍 View Map
Primary Practice Address4802 10th Ave
Brooklyn, NY 11219-2916
United States
Phone: (646) 322-2666
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes363AM0700X – Physician Assistant, MedicalNY020735-1
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About NPI 1174057012

Moshe Michael Borohov PA is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1174057012. The primary specialty listed is Physician Assistant, Medical. The provider is located in Brooklyn, NY. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2017-04-18. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1174057012?

NPI 1174057012 belongs to Moshe Michael Borohov PA, a Physician Assistant, Medical in Brooklyn, NY. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1174057012 active?

The current status of NPI 1174057012 in the NPPES registry is Active. The record was last updated on 2017-04-18.

What specialty is NPI 1174057012?

NPI 1174057012 is classified under the taxonomy Physician Assistant, Medical. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1174057012?

You can verify NPI 1174057012 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1174057012?

The primary practice address on file for NPI 1174057012 is 4802 10th Ave, Brooklyn, NY 11219-2916. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1174057012 issued?

NPI 1174057012 was first issued (enumerated) on 2017-04-18. The NPPES record was last updated on 2017-04-18.

Practice Location Map

Moshe Michael Borohov is located at 4802 10th Ave, Brooklyn, NY. Use the map below to find directions or verify the practice location.

📍 4802 10th Ave, Brooklyn, NY 11219-2916  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Moshe Michael Borohov. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1174057012. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Physician Assistant, Medical020735-1NY
Data Verified from CMS NPPES Last synced: 2026-08-23 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162