Provider Demographics
NPI:1235233586
Name:BORKSON, JOSEPH L (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:L
Last Name:BORKSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 LOCUST ST
Mailing Address - Street 2:SUITE L
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-4415
Mailing Address - Country:US
Mailing Address - Phone:215-732-8866
Mailing Address - Fax:215-732-8861
Practice Address - Street 1:1530 LOCUST ST
Practice Address - Street 2:SUITE L
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-4415
Practice Address - Country:US
Practice Address - Phone:215-732-8866
Practice Address - Fax:215-732-8861
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 040830-L207R00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD040830LOtherLIC
PA1264110Medicaid
PA155525UXVMedicare ID - Type Unspecified
PA1264110Medicaid