1174880819 NPI number — MRS. LEYLA MARIE RAWAN-BOROWY MSW-LICSW

Table of content: MRS. LEYLA MARIE RAWAN-BOROWY MSW-LICSW (NPI 1174880819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174880819 NPI number — MRS. LEYLA MARIE RAWAN-BOROWY MSW-LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAWAN-BOROWY
Provider First Name:
LEYLA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW-LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174880819
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
51 UNION ST
Provider Second Line Business Mailing Address:
SUITE 222
Provider Business Mailing Address City Name:
WARCESTER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-317-2323
Provider Business Mailing Address Fax Number:
508-519-5619

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
51 UNION STREET, SUIET 222
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WORCESTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01608-1201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
774-239-4316
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/19/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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