Provider Demographics
NPI:1467891481
Name:BORDA, LORENA
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:BORDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8406 109TH ST APT 3B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1238
Mailing Address - Country:US
Mailing Address - Phone:718-730-4106
Mailing Address - Fax:
Practice Address - Street 1:8406 109TH ST APT 3B
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1238
Practice Address - Country:US
Practice Address - Phone:718-730-4106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236087837171M00000X
FL22652225X00000X
NY024697225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator