Provider Demographics
NPI:1679234108
Name:BOROSKY, DANIEL P
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:P
Last Name:BOROSKY
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 1:567 EDWARD LN
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:OH
Mailing Address - Zip Code:44405-1258
Mailing Address - Country:US
Mailing Address - Phone:330-787-3132
Mailing Address - Fax:
Practice Address - Street 1:2401 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-2405
Practice Address - Country:US
Practice Address - Phone:330-743-1015
Practice Address - Fax:330-743-1025
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2308832104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker