Healthcare Provider Details

I. General information

NPI: 1053477240
Provider Name (Legal Business Name): SONIA BORGES LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 03/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 STATE ROUTE 17M
MONROE NY
10950-1643
US

IV. Provider business mailing address

308 RILEY RD
NEW WINDSOR NY
12553-7267
US

V. Phone/Fax

Practice location:
  • Phone: 845-781-5890
  • Fax: 516-599-2185
Mailing address:
  • Phone: 845-567-6912
  • Fax: 516-599-2185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number019141
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number008642-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: