1134303464 NPI number — KAREN MARIE BOROS SLP

Table of content: KAREN MARIE BOROS SLP (NPI 1134303464)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134303464 NPI number — KAREN MARIE BOROS SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOROS
Provider First Name:
KAREN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134303464
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/21/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10700 FRANKSTOWN ROAD
Provider Second Line Business Mailing Address:
SUITE 310
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15235-3066
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-371-4090
Provider Business Mailing Address Fax Number:
412-371-4182

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10700 FRANKSTOWN RD
Provider Second Line Business Practice Location Address:
SUITE 310
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15235-3049
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-371-4090
Provider Business Practice Location Address Fax Number:
412-371-4182
Provider Enumeration Date:
12/21/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SL001905L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 101366202-0001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".