Provider Demographics
NPI:1871589952
Name:BORGATTI, RICHARD JOSEPH JR (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:JOSEPH
Last Name:BORGATTI
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 HOOPER AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2895
Mailing Address - Country:US
Mailing Address - Phone:732-244-4544
Mailing Address - Fax:732-244-4545
Practice Address - Street 1:1430 HOOPER AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2895
Practice Address - Country:US
Practice Address - Phone:732-244-4544
Practice Address - Fax:732-244-4545
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMAO52680207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE53418Medicare UPIN
NJ096052Medicare ID - Type Unspecified