Jonathan Borak, MD

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

19428 Issued in CT

Practice address

234 Church St
New Haven, CT 06510-1804

Phone

(203) 777-6611

Fax

(203) 777-1411

NPI assigned

Sep 15, 2013

Last updated

Sep 15, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379203200000",
    "number": "1053747691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 CHURCH ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065101804",
            "telephone_number": "203-777-6611",
            "fax_number": "203-777-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 CHURCH ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065101804",
            "telephone_number": "203-777-6611",
            "fax_number": "203-777-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORAK",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-15",
        "last_updated": "2013-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CT",
            "license": "19428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Bootes
• Jessica Elaine Bootle, PHARMD
• Ryan Keith Bootle, PHARMD
• Riona Lynn Booze, DO
• Anoli J Borad, MD
• Cara M Borelli
• Marissa Borgese, MD, MS
• Nathaniel I Borochov, MD
• Margaret Boron, MD
• Mark R Boroski, LMFT,LADC, MA,BS

• Preventive Medicine/Occupational Environmental Medicine Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.