Healthcare Provider Details

I. General information

NPI: 1326956947
Provider Name (Legal Business Name): MADELINE MAE BORDNER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 S CEDAR CREST BLVD STE 210
ALLENTOWN PA
18103-6271
US

IV. Provider business mailing address

213 DAYTON ST
WILLIAMSTOWN PA
17098-9513
US

V. Phone/Fax

Practice location:
  • Phone: 610-402-8506
  • Fax:
Mailing address:
  • Phone: 717-383-2036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA067255
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: