Dennis Lawrence Bordan, M.D., F.A.C.S.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

25MA07856500 Issued in NJ

Practice address

201 Lyons Ave
Newark, NJ 07112-2027

Phone

(973) 926-7330

Fax

(973) 923-8757

NPI assigned

Apr 19, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
  • NPI 1689618407
  NPD (past)
• Prohealth Care Associates, LLP

  • Physical Therapist
  • Carmel, NY
  • NPI 1508324898
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1164487559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7330",
            "fax_number": "973-923-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7330",
            "fax_number": "973-923-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDAN",
        "first_name": "DENNIS",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.C.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA07856500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "316641",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie Marie Bonilla
• Kristy Rose Bono
• Gilda Bontempo, M.D
• Lindsey Christine Boody, OD
• Araceli O Borbon-Reyes, M.D.
• Vjollca Borova
• Noah Joseph Borris, APN
• Garrett James Bortiatynski, MD
• Christy Sue Borud, NP
• Taylor Joan Bostonian, MD

• Surgery Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.