Provider Demographics
NPI:1982634713
Name:BORJA, PATRICK M (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:M
Last Name:BORJA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3933 PERKIOMEN AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606
Mailing Address - Country:US
Mailing Address - Phone:610-779-4588
Mailing Address - Fax:610-779-8040
Practice Address - Street 1:3933 PERKIOMEN AVE
Practice Address - Street 2:STE 101
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-2718
Practice Address - Country:US
Practice Address - Phone:610-779-4588
Practice Address - Fax:610-779-8040
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007452L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA79284Medicare UPIN
PA036046Medicare ID - Type Unspecified