Provider Demographics
NPI:1598344558
Name:BORELLI, JEAN GENARO PEREIRA
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:GENARO PEREIRA
Last Name:BORELLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02351-1802
Mailing Address - Country:US
Mailing Address - Phone:617-480-4743
Mailing Address - Fax:
Practice Address - Street 1:280 ADAMS ST
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:MA
Practice Address - Zip Code:02351-1802
Practice Address - Country:US
Practice Address - Phone:617-480-4743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program