Provider Demographics
NPI:1467575506
Name:BORUS, JOSHUA S (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:S
Last Name:BORUS
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 1:196 SOUTH ST
Mailing Address - Street 2:#2
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3928
Mailing Address - Country:US
Mailing Address - Phone:617-524-3356
Mailing Address - Fax:
Practice Address - Street 1:333 LONGWOOD AVE FL 6
Practice Address - Street 2:DEPT OF ADOLESCENT MEDICINE- CHILDREN'S HOSPITAL BOSTON
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5711
Practice Address - Country:US
Practice Address - Phone:617-355-7181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225867208000000X
MA2351312080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics