Healthcare Provider Details
I. General information
NPI: 1700293834
Provider Name (Legal Business Name): KRISTIN LYNN BORREGGINE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/21/2014
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1801 ROCKLAND RD STE 302
WILMINGTON DE
19803
US
IV. Provider business mailing address
PO BOX 191
ROCKLAND DE
19732-0191
US
V. Phone/Fax
- Phone: 302-651-4200
- Fax: 302-651-4543
- Phone: 302-651-4200
- Fax: 302-651-4945
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | C2-0013210 |
| License Number State | DE |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 59864 |
| License Number State | MN |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 036.171343 |
| License Number State | IL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | OS019544 |
| License Number State | PA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 25MB10860100 |
| License Number State | NJ |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | OT017537 |
| License Number State | PA |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | 036.171343 |
| License Number State | IL |
| # 8 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | C2-0013210 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: