Healthcare Provider Details

I. General information

NPI: 1225958762
Provider Name (Legal Business Name): MICHELLE BORGESE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 E 153RD ST
BRONX NY
10455-1307
US

IV. Provider business mailing address

489 E 153RD ST
BRONX NY
10455-1307
US

V. Phone/Fax

Practice location:
  • Phone: 718-742-7106
  • Fax: 718-307-6097
Mailing address:
  • Phone: 718-742-7106
  • Fax: 718-307-6097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: