Carol Anne Borelli

Primary specialty

PsychologistTaxonomy code 103T00000X

License

XXXXX1589 Issued in NY

Practice address

115 Riverwoods Dr
Grand Island, NY 14072-2175

Phone

(716) 773-3023

NPI assigned

Jun 19, 2012

Last updated

Jun 19, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1437412012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 RIVERWOODS DR",
            "city": "GRAND ISLAND",
            "state": "NY",
            "postal_code": "140722175",
            "telephone_number": "716-773-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 RIVERWOODS DR",
            "city": "GRAND ISLAND",
            "state": "NY",
            "postal_code": "140722175",
            "telephone_number": "716-773-3023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORELLI",
        "first_name": "CAROL",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "XXXXX1589",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "XXXXX1589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Grand Island, NY
• Providers in Grand Island, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; 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.