VICKI BORUTA NPI 1124120126

NPI Information

  • NPI: 1124120126
  • Provider Name: VICKI BORUTA
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • Address: 2701 BLAIR MILL RD
    SUITE 8
    WILLOW GROVE, PA
    ZIP 19090
  • Phone: (215) 957-9250

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NPI Details

Vicki Boruta is a medical physician assistant in Willow Grove, PA. Vicki Boruta NPI is 1124120126. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2701 BLAIR MILL RD
SUITE 8
WILLOW GROVE, PA
ZIP 19090-041
Phone: (215) 957-9250
Fax: (215) 957-9254

The enumeration date for this NPI number is 9/1/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalMA000872-LPENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
130702MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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