MEDICARE: EILEEN F BOROWSKI PHD

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
1	103T00000X	Psychologist	PS007864L	PA

General Provider Information

NPI Number	:	1265505101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN F BOROWSKI PHD

Provider Business Mailing Address
First Line	:	PO BOX 20416
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19137-0416
Country	:	US
Telephone Number	:	215-789-6256
Fax Number	:	215-789-6256

Provider Business Practice Location Address
First Line	:	1845 WALNUT ST
Second Line	:	SUITE 945
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-4708
Country	:	US
Telephone Number	:	215-789-6256
Fax Number	:	215-789-6256

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	01/07/2016

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