Individual
EDWARD B BORDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
625 BELLE TERRE RD STE 201, PORT JEFFERSON, NY 11777-2318
(631) 474-0707
(631) 474-4034
Mailing address
333 ROUTE 25A, ROCKY POINT, NY 11778-8556
(631) 474-0707
(631) 474-4034
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
133133
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00718209
—
NY
Enumeration date
07/19/2006
Last updated
10/20/2014
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