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General NPI Number Information
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NPI Number | 1033460233
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Entity Type | Organization
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Legal Business Name | ANDREW J. BORSON
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Dates
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Enumeration Date | 09/27/2012
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Last Update Date | 09/27/2012
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Provider Practice Location Address
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Address Line | 101 CAMBRIDGE RD
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City | BROOMALL
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State | PA
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Zip | 19008-3309
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Country | US
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Telephone | 610-356-0462
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Fax | 610-595-6273
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Provider Business Mailing Address
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Address Line | 101 CAMBRIDGE RD
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City | BROOMALL
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State | PA
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Zip | 19008-3309
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Country | US
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Telephone | 610-356-0462
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Fax | 610-595-6273
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ANDREW J BORSON
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Credential | PH.D.
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Telephone | 610-356-0462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PS-004142-L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS-004142-L
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License Number State | PA
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