Individual
GREGORY WILLIAM BORDIUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1000 BROADWAY, WEST LONG BRANCH, NJ 07764-1308
(732) 571-1366
(732) 571-1366
Mailing address
1000 BROADWAY, WEST LONG BRANCH, NJ 07764-1308
(732) 571-1366
(732) 571-1366
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00147700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1434004
—
NJ
Enumeration date
12/04/2006
Last updated
07/08/2007
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