Provider Demographics
NPI:1689974610
Name:BORBERG, CHRISTIAN JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:JOSE
Last Name:BORBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 FREEPORT ST
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-6071
Mailing Address - Country:US
Mailing Address - Phone:724-594-1140
Mailing Address - Fax:724-594-1143
Practice Address - Street 1:356 FREEPORT ST
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6071
Practice Address - Country:US
Practice Address - Phone:724-594-1140
Practice Address - Fax:724-594-1143
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD446805207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028043820001Medicaid
PA263084Medicare PIN