Provider Demographics
NPI:1851452445
Name:BORRAS, MILDRED (PHD)
Entity Type:Individual
Prefix:DR
First Name:MILDRED
Middle Name:
Last Name:BORRAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 STUYVESANT OVAL APT 8D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2005
Mailing Address - Country:US
Mailing Address - Phone:917-848-4161
Mailing Address - Fax:
Practice Address - Street 1:18 E 93RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0610
Practice Address - Country:US
Practice Address - Phone:212-831-4794
Practice Address - Fax:212-427-6123
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2015-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012847-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist