Provider Demographics
NPI:1750396313
Name:BORODOKER, NATALIE (MD)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:BORODOKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 COVERLY AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-4549
Mailing Address - Country:US
Mailing Address - Phone:718-448-0588
Mailing Address - Fax:
Practice Address - Street 1:2792 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4729
Practice Address - Country:US
Practice Address - Phone:718-517-2555
Practice Address - Fax:718-517-2556
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229403-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology