Borgueta, Custodio Ricacho

Borgueta, Custodio Ricacho is an individual health care provider with primary practice located at 9 Hudson Valley Professional Plz , Newburgh NY 12550-3150. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Borgueta, Custodio Ricacho can be contacted via phone (845) 561-0990.

Contact Information

Primary practice address
9 Hudson Valley Professional Plz Newburgh NY 12550-3150
Phone: (845) 561-0990
Fax: (845) 562-1439
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 154989 New York

Profile Details

NPI number 1245200831
LBN Legal business name Borgueta, Custodio Ricacho
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Jul 15th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245200831 NPPES
New York MEDICAID 00783028

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