Provider Demographics
NPI:1669569414
Name:BORGER, CARYN BETH (MD)
Entity type:Individual
Prefix:DR
First Name:CARYN
Middle Name:BETH
Last Name:BORGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932
Mailing Address - Country:US
Mailing Address - Phone:973-377-6868
Mailing Address - Fax:973-377-6822
Practice Address - Street 1:15 JAMES ST
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932
Practice Address - Country:US
Practice Address - Phone:973-377-6868
Practice Address - Fax:973-377-6822
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA69534174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA69534OtherNJ STATE LICENSE
NJH46922Medicare UPIN
NJ050561MHBMedicare PIN