Individual ProviderBogdan BorisenkoPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address300 State St Ste 301, Erie, PA 16507-1430(814) 877-7907(814) 923-9715PECOS EnrollmentBased on the most recent information from CMS, provider Bogdan Borisenko does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1265274773Provider TypeIndividualFull NameBorisenko, BogdanCredentialPA-CGenderMaleSole ProprietorNoEnumeration Date6/7/2024Last Updated12/11/2024Contact InformationPractice LocationPractice Address300 State St Ste 301, Erie, PA 16507-1430Phone(814) 877-7907FaxUnlisted FaxMailing LocationMailing Address5604 Jones Ln, Erie, PA 16505-1124Phone(814) 923-9715FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363AM0700XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseMA065557PennsylvaniaCode363A00000XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseMA065557Pennsylvania