Custodio Ricacho Borgueta, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

154989 Issued in NY

Practice address

9 Hudson Valley Professional PLZ
Newburgh, NY 12550-3150

Phone

(845) 561-0990

Fax

(845) 562-1439

NPI assigned

Jan 25, 2006

Sex

Male

Sole proprietor

No

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

State licenses

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.

• Womens Medical Care of Hudson Valley PC

  • Obstetrics & Gynecology Physician
  • Newburgh, NY
  • NPI 1144372566
  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1245200831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 HUDSON VALLEY PROFESSIONAL PLZ",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125503150",
            "telephone_number": "845-561-0990",
            "fax_number": "845-562-1439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGUETA",
        "first_name": "CUSTODIO",
        "middle_name": "RICACHO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "154989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00783028",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eileen Gayle Bogursky, M.D.
• Eva Bokor
• Harry N Boltin, M.D.
• Colleen Bordeman, MSED
• Jacqueline R Borgia, RN
• Mark Christian Botti, PHARMD
• Jeffrey Michael Bovee, CASAC-T
• Sonha Bowen
• Leticia Boyer West
• Chaquanna Shatia Boykin

• Obstetrics & Gynecology Physician in Newburgh, NY
• Providers in Newburgh, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; 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.