Lisa Borduin, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

009221 Issued in NY

Practice address

2904 Route 6
Slate Hill, NY 10973-3810

Phone

(845) 355-4611

Fax

(845) 355-2776

NPI assigned

Jul 9, 2006

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Horizon Medical Group, P.C.

  • Durable Medical Equipment & Medical Supplies
  • Yorktown Heights, NY
  • NPI 1386520021
  NPD (past)
• Slate Hill Chemists Inc

  • Community/Retail Pharmacy
  • Slate Hill, NY
  • NPI 1245571116
  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497788632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 N MAIN ST",
            "address_2": "PO BOX 299",
            "city": "FLORIDA",
            "state": "NY",
            "postal_code": "109211133",
            "telephone_number": "845-651-1412",
            "fax_number": "845-651-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 ROUTE 6",
            "city": "SLATE HILL",
            "state": "NY",
            "postal_code": "109733810",
            "telephone_number": "845-355-4611",
            "fax_number": "845-355-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDUIN",
        "first_name": "LISA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "009221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1056042",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA MEDICAL LICENSE",
            "identifier": "25MP00104200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luis Jose Abreu Jr., LMSW
• Stacy Lynn Adjei
• Haris Ashraf, D.O.
• Abigail Bailey, M.S., CCC-SLP
• Mackenzie M Bogart, OTR
• Jesula Charlot-Chatelain
• Jennifer M Christensen
• Michelle Conklin
• Nisha David
• Vanessa Dieudonne, REGISTERED NURSE

• Medical Physician Assistant in Slate Hill, NY
• Providers in Slate Hill, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.