Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Boris Bakanov, NP

Individual provider Adult Health Nurse Practitioner · NPI 1811763576

Boris Bakanov, NP is an Adult Health Nurse Practitioner in New York, New York. Licensed in New York. Registered with an NPI since 2023.

Licensed in
NY
In the registry since
2023
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

440 W 114th St Fl 6
New York, NY 10025-1796
Phone: (212) 523-8570
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence F311621 (NY)

Record details

NPI number1811763576
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedDecember 4, 2023
Last updated in NPPESJanuary 23, 2025
Certification dateJanuary 23, 2025

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