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

Maksim Nisenboym, PA

Individual provider Physician Assistant · NPI 1063785863

Maksim Nisenboym, PA is a Physician Assistant in Briarwood, New York. Licensed in New York. Registered with an NPI since 2012.

Licensed in
NY
In the registry since
2012
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

14755 Hoover Ave
Briarwood, NY 11435-2139
Phone: (718) 523-5674
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 015471 (NY)

Record details

NPI number1063785863
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 10, 2012
Last updated in NPPESFebruary 10, 2012

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