Healthcare Provider Details

I. General information

NPI: 1699899393
Provider Name (Legal Business Name): BORG IMAGING GROUP LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 CLINTON AVE S BLDG 300 SUITE 320
ROCHESTER NY
14618-5720
US

IV. Provider business mailing address

125 LATTIMORE RD
ROCHESTER NY
14620-4159
US

V. Phone/Fax

Practice location:
  • Phone: 585-271-0401
  • Fax: 585-271-2051
Mailing address:
  • Phone: 585-271-0401
  • Fax: 585-271-2051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateNY

VIII. Authorized Official

Name: DANIEL B WOPPERER
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 585-271-0401