Provider Demographics
NPI:1073542288
Name:BORBAS, JUDITH K (MD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:K
Last Name:BORBAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:K
Other - Last Name:BORBAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-368-6419
Mailing Address - Fax:585-368-4439
Practice Address - Street 1:924 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611-3702
Practice Address - Country:US
Practice Address - Phone:585-463-3870
Practice Address - Fax:585-463-3873
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199891207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01674102Medicaid
NY01674102Medicaid
NYRA0103--GRP BA0017Medicare PIN
NYRA0103--GRP BA0017Medicare PIN
NYM77008 - GRP 7008AMedicare PIN