Provider Demographics
NPI:1053477240
Name:BORGES, SONIA (LMT)
Entity Type:Individual
Prefix:MISS
First Name:SONIA
Middle Name:
Last Name:BORGES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 RILEY RD
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-7267
Mailing Address - Country:US
Mailing Address - Phone:845-567-6912
Mailing Address - Fax:516-599-2185
Practice Address - Street 1:1019 STATE ROUTE 17M
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-1643
Practice Address - Country:US
Practice Address - Phone:845-781-5890
Practice Address - Fax:516-599-2185
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019141225700000X
NY008642-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY019141OtherMASSAGE THERAPIST