Provider Demographics
NPI:1023367638
Name:BOROWSKI, GREGORY SCOTT (LPN, EMT)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:SCOTT
Last Name:BOROWSKI
Suffix:
Gender:M
Credentials:LPN, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6304 E PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-6336
Mailing Address - Country:US
Mailing Address - Phone:216-536-7150
Mailing Address - Fax:
Practice Address - Street 1:6304 E PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-6336
Practice Address - Country:US
Practice Address - Phone:216-536-7150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH158474146N00000X
OHPN.140647-MEDS164W00000X
TX227553164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No164X00000XNursing Service ProvidersLicensed Vocational Nurse