Provider Demographics
NPI:1063409951
Name:BOKSAY, ISTVAN EJ (MD)
Entity type:Individual
Prefix:
First Name:ISTVAN
Middle Name:EJ
Last Name:BOKSAY
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 1:330 E 38TH ST
Mailing Address - Street 2:APT 33E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2743
Mailing Address - Country:US
Mailing Address - Phone:212-263-5108
Mailing Address - Fax:
Practice Address - Street 1:314 E 30TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8303
Practice Address - Country:US
Practice Address - Phone:646-370-2050
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-05
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1572152084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00892411Medicaid
NYB14986Medicare UPIN
NY00892411Medicaid