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NPI Code Detail

MEDICARE: DR. STANLEY J BORDEN D.O.

MEDICARE: DR. STANLEY J BORDEN D.O.
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
1207W00000XOphthalmology PhysicianOS002955LPA

General Provider Information

NPI Number : 1215373576
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STANLEY J BORDEN D.O.
Provider Business Mailing Address
First Line : 221 N 23RD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19103-1005
Country : US
Telephone Number : 215-988-1220
Fax Number :
Provider Business Practice Location Address
First Line : 221 N 23RD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19103-1005
Country : US
Telephone Number : 215-988-1220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2013
Last Update Date : 05/14/2013

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