Individual
CUSTODIO RICACHO BORGUETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9 HUDSON VALLEY PROFESSIONAL PLZ, NEWBURGH, NY 12550-3150
(845) 561-0990
(845) 562-1439
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
154989
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00783028
—
NY
Enumeration date
01/25/2006
Last updated
07/15/2011
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