Individual ProviderBoaz EladStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address630 W 168th St, New York, NY 10032(212) 305-2500PECOS EnrollmentBased on the most recent information from CMS, provider Boaz Elad 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 2 days ago.Profile DetailsProvider ID1417641879Provider TypeIndividualFull NameElad, BoazTitleDr.CredentialM.DGenderMaleSole ProprietorNoEnumeration Date6/7/2023Last Updated12/7/2023Contact InformationPractice LocationPractice Address630 W 168th St, New York, NY 10032Phone(212) 305-2500FaxUnlisted FaxMailing LocationMailing Address630 W 168th St, New York, NY 10032Phone(212) 305-2500FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer