Healthcare Provider Details

I. General information

NPI: 1679922934
Provider Name (Legal Business Name): ARIANNE BORDA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 12/30/2022
Certification Date: 12/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4417 VESTAL PKWY E
VESTAL NY
13850-3556
US

IV. Provider business mailing address

33 LEWIS RD FL 2
BINGHAMTON NY
13905
US

V. Phone/Fax

Practice location:
  • Phone: 607-797-1251
  • Fax: 607-729-4393
Mailing address:
  • Phone: 607-770-0025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number299584
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: