Active NPI
Christine Carol Borelli, PHD
- Psychologist
- Sag Harbor, NY
National Provider Identifier
1598978322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 018385
- Practice address
- 3297 Noyac Rd
Sag Harbor, NY 11963-1942 - Phone
- (631) 903-7886
- NPI assigned
- May 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | SS772 | FL | |
| Psychologist | 103T00000X | 018385 | NY | Primary |
Addresses
Primary practice location
3297 Noyac Rd
Sag Harbor, NY 11963-1942
Mailing address
PO Box 1605
Sag Harbor, NY 11963-0058
Phone (631) 903-7886
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03163435 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SS772 | FL | MD | Psychologist |
| 018385 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410480000000",
"number": "1598978322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1605",
"city": "SAG HARBOR",
"state": "NY",
"postal_code": "119630058",
"telephone_number": "631-903-7886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3297 NOYAC RD",
"city": "SAG HARBOR",
"state": "NY",
"postal_code": "119631942",
"telephone_number": "631-903-7886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORELLI",
"first_name": "CHRISTINE",
"middle_name": "CAROL",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2014-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "SS772",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "018385",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03163435",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sag Harbor, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.