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General NPI Number Information
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NPI Number | 1972771772
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Entity Type | Individual
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Provider Name | ANDREW MICHAEL BORUTA DO
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Gender | Male
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Dates
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Enumeration Date | 02/14/2008
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 250 OLD HOOK RD
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City | WESTWOOD
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State | NJ
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Zip | 07675-3123
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Country | US
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Telephone | 201-383-1035
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Fax |
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Provider Business Mailing Address
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Address Line | 25 MAIN ST STE 103
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City | HACKENSACK
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State | NJ
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Zip | 07601-7032
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Country | US
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Telephone | 201-488-0066
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Fax | 201-488-7048
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MB08899300
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License Number State | NJ
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