Provider Demographics
NPI:1467405076
Name:BORDAS, CHRISTINE (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:BORDAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 HUNGRY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10977-6111
Mailing Address - Country:US
Mailing Address - Phone:845-356-8494
Mailing Address - Fax:845-356-8468
Practice Address - Street 1:241 HUNGRY HOLLOW RD
Practice Address - Street 2:
Practice Address - City:CHESTNUT RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10977-6111
Practice Address - Country:US
Practice Address - Phone:845-353-5600
Practice Address - Fax:845-353-3474
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303780363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02631152Medicaid
NY0566G1Medicare UPIN