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NPI Code Detail

MEDICARE: VICTOR DANIEL BORKOWSKI O.D.

MEDICARE: VICTOR DANIEL BORKOWSKI O.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
1152W00000XOptometrist270A00411700NJ

Other Identifiers

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

General Provider Information

NPI Number : 1932153079
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTOR DANIEL BORKOWSKI O.D.
Provider Business Mailing Address
First Line : 1700 MADISON AVE
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-1253
Country : US
Telephone Number : 732-367-1881
Fax Number : 732-367-2462
Provider Business Practice Location Address
First Line : 1700 MADISON AVE
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-1253
Country : US
Telephone Number : 732-367-1881
Fax Number : 732-367-2462
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2006
Last Update Date : 03/20/2012

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