Provider Demographics
NPI:1457623704
Name:BORUFF, DEBORAH MONTE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:MONTE
Last Name:BORUFF
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 1:495 HOFFMAN LN
Mailing Address - Street 2:P.O. BOX 6006
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-3102
Mailing Address - Country:US
Mailing Address - Phone:631-870-5784
Mailing Address - Fax:631-360-5622
Practice Address - Street 1:495 HOFFMAN LN
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-3102
Practice Address - Country:US
Practice Address - Phone:631-870-5784
Practice Address - Fax:631-360-5622
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011848103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool