Provider Demographics
NPI:1124802798
Name:BORJA, ANGELICA (PT, DPT)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:BORJA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 NAGLE DR
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1722
Mailing Address - Country:US
Mailing Address - Phone:908-392-2190
Mailing Address - Fax:
Practice Address - Street 1:552 ALLEN RD
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-3848
Practice Address - Country:US
Practice Address - Phone:908-605-0125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02187700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist