{
"Npi": {
"NPI": "1770801599",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BORDONARO",
"FirstName": "DEBORAH",
"MiddleName": "ANN",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "PA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "VOGEL",
"OtherFirstName": "DEBORAH",
"OtherMiddleName": "ANN",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PA",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1866 WADING RIVER MANOR RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WADING RIVER",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11792-2137",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "631-910-4200",
"MailingAddressFaxNumber": "718-875-7606",
"FirstLinePracticeLocationAddress": "1866 WADING RIVER MANOR RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WADING RIVER",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11792-2137",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "631-910-4200",
"PracticeLocationAddressFaxNumber": "631-875-7606",
"EnumerationDate": "05/05/2010",
"LastUpdateDate": "10/13/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "004021",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}