Provider Demographics
NPI:1558430074
Name:BORSINI, ERIC M (DC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:M
Last Name:BORSINI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 PORTSMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-4433
Mailing Address - Country:US
Mailing Address - Phone:937-876-9209
Mailing Address - Fax:
Practice Address - Street 1:25 PORTSMOUTH AVE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03109-4433
Practice Address - Country:US
Practice Address - Phone:937-876-9209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000385435OtherANTHEM
OH2357168Medicaid
OH20-3788139OtherUHC
OHBO4080695Medicare ID - Type Unspecified
OH20-3788139OtherUHC