Provider Demographics
NPI:1023331915
Name:BORRELLI, NIEL J (MD)
Entity type:Individual
Prefix:DR
First Name:NIEL
Middle Name:J
Last Name:BORRELLI
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 1:615 OLD NEW WINDSOR PIKE
Mailing Address - Street 2:PO BX 50
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6748
Mailing Address - Country:US
Mailing Address - Phone:410-876-2292
Mailing Address - Fax:
Practice Address - Street 1:615 OLD NEW WINDSOR PIKE
Practice Address - Street 2:PO BX 50
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6748
Practice Address - Country:US
Practice Address - Phone:410-876-2292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00134242085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology