Individual
MRS. COURTNEY DEAN BORRUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2131 LAKE AVE SUITE 4, ASHTABULA, OH 44004
(440) 964-3733
(440) 964-7069
Mailing address
2131 LAKE AVE. SUITE 4, ASHTABULA, OH 44004
(440) 964-3733
(440) 964-7069
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34.011500
OH
207R00000X
Internal Medicine Physician
OS015061
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002518014
HIGHMARK BCBS
PA
05
—
1024998940003
—
PA
Enumeration date
07/21/2008
Last updated
04/10/2015
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