Provider Demographics
NPI:1063410959
Name:BOROFSKI SIEGAL, ANN MARIE (MD)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:BOROFSKI SIEGAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:BOROFSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:701 EAST MARSHALL STREET
Mailing Address - Street 2:CHESTER COUNTY HOSPITAL, RADIATION ONCOLOGY
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380
Mailing Address - Country:US
Mailing Address - Phone:610-431-5530
Mailing Address - Fax:610-431-5144
Practice Address - Street 1:701 EAST MARSHALL STREET
Practice Address - Street 2:CHESTER COUNTY HOSPITAL, RADIATION ONCOLOGY
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380
Practice Address - Country:US
Practice Address - Phone:610-431-5530
Practice Address - Fax:610-431-5144
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041921L2085R0001X, 2085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017142600004Medicaid
PA0017142600004Medicaid
PA127232Medicare PIN