Provider Demographics
NPI:1508041617
Name:STEPHAN Z BORBELY DPM
Entity Type:Organization
Organization Name:STEPHAN Z BORBELY DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHAN
Authorized Official - Middle Name:Z
Authorized Official - Last Name:BORBELY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:201-703-3330
Mailing Address - Street 1:511 BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407
Mailing Address - Country:US
Mailing Address - Phone:201-703-3330
Mailing Address - Fax:201-703-3332
Practice Address - Street 1:511 BOULEVARD
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407
Practice Address - Country:US
Practice Address - Phone:201-703-3330
Practice Address - Fax:201-703-3332
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEPHAN Z BORBELY DPM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-08
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0954280001335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU31474Medicare UPIN
NJ0954280001Medicare NSC