Provider Demographics
NPI:1598403578
Name:BORISH, ALEC CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:ALEC
Middle Name:CHRISTOPHER
Last Name:BORISH
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 1:7411 BERTHA AVE
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-3101
Mailing Address - Country:US
Mailing Address - Phone:216-262-3562
Mailing Address - Fax:
Practice Address - Street 1:7411 BERTHA AVE
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-3101
Practice Address - Country:US
Practice Address - Phone:216-262-3562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0002621175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist