Provider Demographics
NPI:1528021953
Name:BORIN, LANA M (MD)
Entity Type:Individual
Prefix:DR
First Name:LANA
Middle Name:M
Last Name:BORIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LANA
Other - Middle Name:
Other - Last Name:SHILOVITSKIY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2401 W BELVEDERE AVE
Mailing Address - Street 2:DEPT OF CREDENTIALING
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5216
Mailing Address - Country:US
Mailing Address - Phone:410-601-5524
Mailing Address - Fax:410-601-8946
Practice Address - Street 1:2401 W BELVEDERE AVE
Practice Address - Street 2:DEPT OF PSYCHIATRY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5216
Practice Address - Country:US
Practice Address - Phone:410-601-5457
Practice Address - Fax:410-601-6302
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD550112084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH34581Medicare UPIN
MDS582A449Medicare PIN