Healthcare Provider Details

I. General information

NPI: 1306232517
Provider Name (Legal Business Name): ROBYN M BORSUK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 10/01/2026
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15-17 KENNEDY PARKWAY
CORTLAND NY
13045
US

IV. Provider business mailing address

15-17 KENNEDY PARKWAY
CORTLAND NY
13045
US

V. Phone/Fax

Practice location:
  • Phone: 607-753-3051
  • Fax: 607-753-7735
Mailing address:
  • Phone: 607-753-3051
  • Fax: 607-753-7735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number320221
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: