Healthcare Provider Details

I. General information

NPI: 1639143142
Provider Name (Legal Business Name): GUILLERMO BORRERO, M.D. & ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 02/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 COAL VALLEY RD SUITE 303
CLAIRTON PA
15025-3730
US

IV. Provider business mailing address

575 COAL VALLEY RD SUITE 303
CLAIRTON PA
15025-3730
US

V. Phone/Fax

Practice location:
  • Phone: 412-469-8933
  • Fax: 412-466-2990
Mailing address:
  • Phone: 412-469-8933
  • Fax: 412-466-2990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW001033L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD033759L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: CARRIE JEAN PISANI
Title or Position: ADMINISTRATIVE DIRECTOR
Credential: MBA
Phone: 412-469-8933