Basic Information
| Provider Information | |||||||||
| NPI: | 1982861290 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BORRERO | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6060 RIDGE AVE | ||||||||
| Address2: | STE 100 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191281659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182946200 | ||||||||
| FaxNumber: | 7182946259 | ||||||||
| Practice Location | |||||||||
| Address1: | 2024 CRESTON AVE | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104534244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182946200 | ||||||||
| FaxNumber: | 7182946259 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2008 | ||||||||
| LastUpdateDate: | 04/16/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD451155 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.