Provider Demographics
NPI:1528016755
Name:HRICZ-BORGES, LINDA M (PA-C)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:HRICZ-BORGES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:M HRICZ
Other - Last Name:BORGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:130 DIVISION ST FL 1
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:CT
Mailing Address - Zip Code:06418-1326
Mailing Address - Country:US
Mailing Address - Phone:203-732-1257
Mailing Address - Fax:203-732-2470
Practice Address - Street 1:130 DIVISION ST FL 1
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418-1326
Practice Address - Country:US
Practice Address - Phone:203-732-1257
Practice Address - Fax:203-732-2470
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000322363A00000X, 363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant