Provider Demographics
NPI:1235226044
Name:BORZONE, ROBERT WILLIAM (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:BORZONE
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 EILEEN WAY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-5314
Mailing Address - Country:US
Mailing Address - Phone:516-802-4500
Mailing Address - Fax:516-802-4500
Practice Address - Street 1:115 EILEEN WAY
Practice Address - Street 2:SUITE 107
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-5314
Practice Address - Country:US
Practice Address - Phone:516-802-4500
Practice Address - Fax:516-802-4500
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003459111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX19251Medicare UPIN