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NPI Code Detail

MEDICARE: MRS. BRIDGET BORODYANSKY PA-C

MEDICARE: MRS. BRIDGET BORODYANSKY PA-C
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
1363A00000XPhysician Assistant25MP00987900NJ

General Provider Information

NPI Number : 1699126557
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRIDGET BORODYANSKY PA-C
Provider Business Mailing Address
First Line : 1209 LIBERTY BELL DR
Second Line :
City : CHERRY HILL
State : NJ
Zip : 08003-2758
Country : US
Telephone Number : 610-717-8058
Fax Number :
Provider Business Practice Location Address
First Line : 10800 KNIGHTS RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19114-4200
Country : US
Telephone Number : 215-612-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2016
Last Update Date : 01/08/2026

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