Provider Demographics
NPI:1255970711
Name:BORJA, KAREN (IBCLC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BORJA
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4955
Mailing Address - Country:US
Mailing Address - Phone:732-996-6610
Mailing Address - Fax:732-471-9303
Practice Address - Street 1:209 UNION AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4955
Practice Address - Country:US
Practice Address - Phone:732-996-6610
Practice Address - Fax:732-471-9303
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJL-108789174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN