Provider Demographics
NPI:1700637386
Name:BORKO, CHANDA LEE (CNA)
Entity Type:Individual
Prefix:
First Name:CHANDA
Middle Name:LEE
Last Name:BORKO
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-3831
Mailing Address - Country:US
Mailing Address - Phone:937-977-0672
Mailing Address - Fax:
Practice Address - Street 1:50 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-3831
Practice Address - Country:US
Practice Address - Phone:937-977-0672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide