Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 35084761 | OH |
NPI | 1033104435 |
---|---|
Provider Name | Lisa Marie Borkowski |
First Address | Columbus, OH 43215 |
Second Address | Columbus, OH 43215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 20/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2496768 | (05) | OH |
H07587 | (02) | |
P00147445 | RAILROAD MEDICARE (01) |