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General NPI Number Information
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NPI Number | 1093723264
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Entity Type | Individual
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Provider Name | RICHARD A. BORDOWITZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 29 NORTH HAMILTON HUDSON RIVER HEALTHCARE, INC.
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City | POUGHKEEPSIE
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State | NY
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Zip | 12601
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Country | US
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Telephone | 845-454-8204
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Fax | 845-454-8247
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Provider Business Mailing Address
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Address Line | 1200 BROWN ST FL 4 HUDSON RIVER HEALTHCARE, INC.
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City | PEEKSKILL
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State | NY
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Zip | 10566-3617
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Country | US
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Telephone | 914-734-8858
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Fax | 914-734-8745
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 214219
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License Number State | NY
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