Provider Demographics
NPI:1225637895
Name:BORJA, RODINE CHARLES (PT, DPT)
Entity Type:Individual
Prefix:
First Name:RODINE CHARLES
Middle Name:
Last Name:BORJA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 NAGLE DR
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1722
Mailing Address - Country:US
Mailing Address - Phone:908-392-6486
Mailing Address - Fax:
Practice Address - Street 1:7 LINCOLN HWY STE 101A
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3965
Practice Address - Country:US
Practice Address - Phone:732-662-1800
Practice Address - Fax:732-662-1801
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01962600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist