Provider Demographics
NPI:1700864592
Name:BORER, JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:BORER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:CHILDRENS UROLOGICAL FOUNDATION
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:617-355-8338
Mailing Address - Fax:617-730-0474
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:CHILDRENS UROLOGICAL FOUNDATION
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-8338
Practice Address - Fax:617-730-0474
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA157718208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
30011521OtherWNH
P2697366OtherOXFORD
1900234OtherUHP
36173OtherFCHP
994719OtherNETHE
AA8296OtherHPHC
Z11048OtherHEALT
157718OtherTUFTS
1900234OtherUNI4
000000009227OtherBMC
MA03179630Medicaid
1900234OtherMETRA
1900234OtherUNI1
1900234OtherUNI7
601850OtherHPHC
0012835OtherNHP
11273OtherHNE
8372441001OtherCIG2
994719OtherNETHE