1598976326 NPI number — OAKDALE EAR, NOSE & THROAT CLINIC, P.A.

Table of content: SILVIA MARIA BORGES BSW (NPI 1508379710)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598976326 NPI number — OAKDALE EAR, NOSE & THROAT CLINIC, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OAKDALE EAR, NOSE & THROAT CLINIC, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598976326
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3366 OAKDALE AVE N STE 150
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROBBINSDALE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55422-2961
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-233-5755
Provider Business Mailing Address Fax Number:
763-233-5782

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3366 OAKDALE AVE N STE 150
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROBBINSDALE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55422-2961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-233-5755
Provider Business Practice Location Address Fax Number:
763-233-5782
Provider Enumeration Date:
05/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LYDEEN
Authorized Official First Name:
MARYA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
763-233-5775

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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