Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | NY147901 | NY |
NPI | 1740447101 |
---|---|
Provider Name | Dr. Bernard Charles Borkowski |
First Address | Merrick, NY 11566-5508 |
Second Address | Merrick, NY 11566-5508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 21/05/2008 |