Healthcare Provider Details
I. General information
NPI: 1003443326
Provider Name (Legal Business Name): VINCENT BORJA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/25/2020
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
225 MAY ST STE A
EDISON NJ
08837-3266
US
IV. Provider business mailing address
331 NEWMAN SPRINGS RD STE 220
RED BANK NJ
07701-5792
US
V. Phone/Fax
- Phone: 732-549-7364
- Fax: 732-745-6017
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 25MA12178100 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: