Provider Demographics
NPI:1164599627
Name:BORCICH, ANTHONY STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:STEVEN
Last Name:BORCICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1061
Mailing Address - Country:US
Mailing Address - Phone:212-722-8400
Mailing Address - Fax:212-369-0480
Practice Address - Street 1:1049 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-1061
Practice Address - Country:US
Practice Address - Phone:212-722-8400
Practice Address - Fax:212-369-0480
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY164278207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNS2118OtherOXFORD PIN
NY10F141OtherBLUE CROSS BLUE SHIELD
NYD91942Medicare UPIN
NY10F141Medicare ID - Type Unspecified