MEDICARE: PRINSI BORAD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	055309	NY

General Provider Information

NPI Number	:	1073477378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRINSI BORAD

Provider Business Mailing Address
First Line	:	8746 20TH AVE # L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4802
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	798 SOUTHERN BLVD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-2115
Country	:	US
Telephone Number	:	718-648-0888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/12/2025

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Directions to “ PRINSI BORAD ” Practice Location

Language	Start Address	Practice Location

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