Provider Demographics
NPI:1336588573
Name:BORKO, EVITA NOELLE (LMSW)
Entity Type:Individual
Prefix:
First Name:EVITA
Middle Name:NOELLE
Last Name:BORKO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 BATCHELDER ST APT 5M
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1546
Mailing Address - Country:US
Mailing Address - Phone:917-577-8737
Mailing Address - Fax:
Practice Address - Street 1:2520 BATCHELDER ST APT 5M
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1546
Practice Address - Country:US
Practice Address - Phone:917-577-8737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088663104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker