MEDICARE: MICHAEL BORECKY 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	207RC0000X	Cardiovascular Disease Physician	110906	NY

General Provider Information

NPI Number	:	1861658320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL BORECKY M.D.

Provider Business Mailing Address
First Line	:	80 29TH ST
Second Line	:	HEALTH SERVICE UNIT
City	:	BROOKLYN
State	:	NY
Zip	:	11232-1503
Country	:	US
Telephone Number	:	718-840-4200
Fax Number	:	718-840-5041

Provider Business Practice Location Address
First Line	:	80 29TH ST
Second Line	:	HEALTH SERVICE UNIT
City	:	BROOKLYN
State	:	NY
Zip	:	11232-1503
Country	:	US
Telephone Number	:	718-840-4200
Fax Number	:	718-840-5041

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

Provider Enumeration Date	:	08/04/2008
Last Update Date	:	08/04/2008

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