1841495116 NPI number — BORIS KARPOVSKY, M.D., LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841495116 NPI number — BORIS KARPOVSKY, M.D., LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BORIS KARPOVSKY, M.D., LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841495116
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
199 COOLIDGE AVE
Provider Second Line Business Mailing Address:
UNIT 313
Provider Business Mailing Address City Name:
WATERTOWN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02472-1557
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-926-5268
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
280 WASHINGTON ST
Provider Second Line Business Practice Location Address:
SUITE 304
Provider Business Practice Location Address City Name:
BRIGHTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02135-3511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-789-5333
Provider Business Practice Location Address Fax Number:
617-789-4457
Provider Enumeration Date:
06/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KARPOVSKY
Authorized Official First Name:
BORIS
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
617-926-5268

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  43860 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: 43860 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: J10609 . This is a "BCBS OF MASS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 646734 . This is a "HARVARD PILGRIM HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3073424 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com