Georgiana Borda
Individual provider Active NPI Specialist · Islip, NY
NPI 1750424917 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1750424917
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 011150-1 (NY)
- Practice address
- 252 Islip Ave
Islip, NY 11751-3015 - Phone
- (631) 581-6800
- Fax
- (631) 581-6814
- NPI assigned
- Feb 15, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011150-1 | NY | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids in Action | Past | Accepting new patients | |
| Kids in Action of L.I. Inc. | Specialist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 011150-1 | NY | Yes |
Addresses
Primary practice location
252 Islip Ave
Islip, NY 11751-3015
Mailing address
112 Cardinal LN
Apt 21a
Islip, NY 11751-3231
Phone (631) 793-7689
Other providers in Islip, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.