Borden, Edward B

Borden, Edward B is an sole proprietor health care provider with primary practice located at 625 Belle Terre Rd Ste 201 , Port Jefferson NY 11777-2318. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Borden, Edward B can be contacted via phone (631) 474-0707.

Contact Information

Primary practice address
625 Belle Terre Rd Ste 201 Port Jefferson NY 11777-2318
Phone: (631) 474-0707
Fax: (631) 474-4034
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 133133 New York

Profile Details

NPI number 1316966245
LBN Legal business name Borden, Edward B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 19th, 2006
Last updated Oct 20th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316966245 NPPES
New York MEDICAID 00718209

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