Individual
DR. MARK B BORG JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1133 BROADWAY, SUITE 920, NEW YORK, NY 10010-8218
(212) 978-0266
(212) 741-1697
Mailing address
1133 BROADWAY, SUITE 920, NEW YORK, NY 10010-8218
(212) 978-0266
(212) 741-1697
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
013891
NY
103TC0700X
Clinical Psychologist
013891
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01943402
—
NY
Enumeration date
02/13/2007
Last updated
08/01/2012
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