Provider Demographics
NPI:1497179030
Name:BORRA, JANET (RD)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:
Last Name:BORRA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 COLUMBUS AVE
Mailing Address - Street 2:LOWR LEVEL
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1326
Mailing Address - Country:US
Mailing Address - Phone:914-347-0162
Mailing Address - Fax:914-347-4401
Practice Address - Street 1:19 BRADHURST AVE STE 1700
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2139
Practice Address - Country:US
Practice Address - Phone:914-347-0162
Practice Address - Fax:914-347-4401
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY851553133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered