Provider Demographics
NPI:1477767820
Name:BORKOW, RICHARD BURT (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BURT
Last Name:BORKOW
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 1:11 DEERFOOT LN
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-3315
Mailing Address - Country:US
Mailing Address - Phone:914-693-8498
Mailing Address - Fax:
Practice Address - Street 1:95 BRADHURST AVE
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1637
Practice Address - Country:US
Practice Address - Phone:914-592-7555
Practice Address - Fax:914-592-4776
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1046102081H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081H0002XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCO8853Medicare UPIN