Provider Demographics
NPI:1659660090
Name:BORJA, NEIL A (DO)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:A
Last Name:BORJA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:54 W TWIN OAKS TER STE 12
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7141
Mailing Address - Country:US
Mailing Address - Phone:802-343-2659
Mailing Address - Fax:802-499-2545
Practice Address - Street 1:54 W TWIN OAKS TER STE 12
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7141
Practice Address - Country:US
Practice Address - Phone:802-343-2659
Practice Address - Fax:802-499-2545
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT032.0133990202D00000X, 204D00000X, 171100000X
VT0320133990207Q00000X
OH34.012111207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2015-01495OtherMEDICAL LICENSE
OH34.012111OtherMEDICAL LICENSE