Healthcare Provider Details

I. General information

NPI: 1891600730
Provider Name (Legal Business Name): EMILY LOUISE BORDLEMAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 N CAYUGA ST
ITHACA NY
14850-4291
US

IV. Provider business mailing address

125 PARK PL APT 1
ITHACA NY
14850-4028
US

V. Phone/Fax

Practice location:
  • Phone: 607-280-7360
  • Fax:
Mailing address:
  • Phone: 607-280-7360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: