MEDICARE: DR. RAFFAELE BORRIELLO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	150860	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316941214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAFFAELE BORRIELLO M.D.

Provider Business Mailing Address
First Line	:	141 COMBS AVE
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-1432
Country	:	US
Telephone Number	:	516-569-0696
Fax Number	:	516-569-3677

Provider Business Practice Location Address
First Line	:	50 COURT ST FL 6
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201
Country	:	US
Telephone Number	:	718-625-0767
Fax Number	:	718-625-2487

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	12/29/2022

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