MEDICARE: FERNANDO J BORREGO MD

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	207RI0200X	Infectious Disease Physician	237162	NY
2	207RA0401X	Addiction Medicine (Internal Medicine) Physician	61-18162	NY

General Provider Information

NPI Number	:	1548288277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FERNANDO J BORREGO MD

Provider Business Mailing Address
First Line	:	2369 2ND AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-3108
Country	:	US
Telephone Number	:	212-876-2300
Fax Number	:	212-369-8209

Provider Business Practice Location Address
First Line	:	2369 2ND AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-3108
Country	:	US
Telephone Number	:	212-876-2300
Fax Number	:	212-369-8209

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	07/31/2025

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