Individual
CHARLES BORDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
59 DEAN STREET, ISLANDIA, NY 11749-1715
(631) 786-9418
Mailing address
59 DEAN STREET, ISLANDIA, NY 11749-1715
(631) 786-9418
(631) 630-6527
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
295085-1
NY
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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