Individual ProviderNisa BorwornthammaratRegistered NurseNursing Service ProvidersPractice Address230 N Main St, Spring Valley, NY 10977-4020(845) 363-8140PECOS EnrollmentBased on the most recent information from CMS, provider Nisa Borwornthammarat does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:54 AM.Profile DetailsProvider ID1184145831Provider TypeIndividualFull NameBorwornthammarat, NisaGenderFemaleSole ProprietorYesEnumeration Date7/3/2017Last Updated7/3/2017Contact InformationPractice LocationPractice Address230 N Main St, Spring Valley, NY 10977-4020Phone(845) 363-8140FaxUnlisted FaxMailing LocationMailing Address230 N Main St, Spring Valley, NY 10977-4020PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense635532New York