Provider Demographics
NPI:1497782395
Name:BORISLOW, STEVEN M (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:BORISLOW
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 1:250 KING OF PRUSSIA RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:RADNOR
Mailing Address - State:PA
Mailing Address - Zip Code:19087-5235
Mailing Address - Country:US
Mailing Address - Phone:610-902-1800
Mailing Address - Fax:610-902-1804
Practice Address - Street 1:250 KING OF PRUSSIA RD
Practice Address - Street 2:
Practice Address - City:RADNOR
Practice Address - State:PA
Practice Address - Zip Code:19087-5235
Practice Address - Country:US
Practice Address - Phone:610-902-1800
Practice Address - Fax:610-902-1804
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD067831L2085R0202X
NJ25MA088597002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018193050001Medicaid
PA027011Medicare PIN
PA0018193050001Medicaid