Provider Demographics
NPI:1063445047
Name:BORCIK, BARBARA ANN (MS, RD, LD, CDE)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:BORCIK
Suffix:
Gender:F
Credentials:MS, RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 FAIRMOUNT AVE
Mailing Address - Street 2:STE 400
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5466
Mailing Address - Country:US
Mailing Address - Phone:410-494-1324
Mailing Address - Fax:410-494-1361
Practice Address - Street 1:750 MAIN ST
Practice Address - Street 2:310
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-2515
Practice Address - Country:US
Practice Address - Phone:410-526-3061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00061133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
1142675OtherAETNA HMO
MD36259Medicaid
039510OtherJOHNS HOPKINS HEALTHCARE
112478OtherCOVENTRY
2140424OtherUNITED HEALTHCARE
76956112OtherCAREFIRST MARYLAND
0076OtherCAREFIRST DC
MD850002900Medicaid
286271OtherMAMSI
7064726OtherAETNA PPO
228457OtherKAISER
MD850002900Medicaid
MD157676Medicare PIN
MD850002900Medicaid