Healthcare Provider Details

I. General information

NPI: 1528136884
Provider Name (Legal Business Name): JOANNE BORGMAN MS RN CNS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 W 79TH ST SUITE 1D
NEW YORK NY
10024-6470
US

IV. Provider business mailing address

124 W 79TH ST SUITE 1D
NEW YORK NY
10024-6470
US

V. Phone/Fax

Practice location:
  • Phone: 212-721-8229
  • Fax: 212-579-7785
Mailing address:
  • Phone: 212-721-8229
  • Fax: 212-579-7785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number263244
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberF400081
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: