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NPI Code Detail

MEDICARE: MIHAELA BORAN M.D.

MEDICARE: MIHAELA BORAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician044408CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
123187OTHERALMEDICAL LICENSE
2044408OTHERCTCT MEDICAL LICENSE

General Provider Information

NPI Number : 1427058478
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIHAELA BORAN M.D.
Provider Business Mailing Address
First Line : 130 DIVISION ST
Second Line :
City : DERBY
State : CT
Zip : 06418-1326
Country : US
Telephone Number : 203-735-7421
Fax Number :
Provider Business Practice Location Address
First Line : 130 DIVISION ST
Second Line :
City : DERBY
State : CT
Zip : 06418-1326
Country : US
Telephone Number : 203-735-7421
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 03/07/2023

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