Provider Demographics
NPI:1285893040
Name:BORGSTEDT, AGNETA D (MD)
Entity type:Individual
Prefix:DR
First Name:AGNETA
Middle Name:D
Last Name:BORGSTEDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:88 CHURCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14467-1064
Mailing Address - Country:US
Mailing Address - Phone:585-334-2323
Mailing Address - Fax:585-359-1739
Practice Address - Street 1:88 CHURCH HILL RD
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467-1064
Practice Address - Country:US
Practice Address - Phone:585-334-2323
Practice Address - Fax:585-359-1739
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0854032080P0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities