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General NPI Number Information
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NPI Number | 1790989788
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Entity Type | Individual
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Provider Name | MRS. MICHELLE CINE BORDES
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Gender | Female
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 30 GAYNOR AVE
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City | NESCONSET
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State | NY
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Zip | 11767-1828
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Country | US
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Telephone | 631-265-4291
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Fax |
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Provider Business Mailing Address
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Address Line | 59 DEAN ST
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City | ISLANDIA
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State | NY
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Zip | 11749-1715
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Country | US
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Telephone | 631-630-0664
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Fax |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 216749-1
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License Number State | NY
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