Provider Demographics
NPI:1033460233
Name:ANDREW J. BORSON
Entity Type:Organization
Organization Name:ANDREW J. BORSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:BORSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-356-0462
Mailing Address - Street 1:101 CAMBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3309
Mailing Address - Country:US
Mailing Address - Phone:610-356-0462
Mailing Address - Fax:610-595-6273
Practice Address - Street 1:101 CAMBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3309
Practice Address - Country:US
Practice Address - Phone:610-356-0462
Practice Address - Fax:610-595-6273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-004142-L103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty