Charles N. Borromeo, MED, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

25MT00058300 Issued in NJ

Practice address

901 Route 73 N Ste B
Marlton, NJ 08053-2034

Phone

(856) 222-9713

Fax

(856) 222-9714

NPI assigned

Jul 6, 2006

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1780616417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SILVER HILL LN",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434731",
            "telephone_number": "609-636-7441",
            "fax_number": "856-222-9714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 ROUTE 73 N STE B",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532034",
            "telephone_number": "856-222-9713",
            "fax_number": "856-222-9714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORROMEO",
        "first_name": "CHARLES",
        "middle_name": "N.",
        "name_prefix": "Mr.",
        "credential": "MED, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00058300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATA BOC CERT #",
            "identifier": "029402422",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY LICENSE/REG #",
            "identifier": "25MT00058300",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-2 ORGANIZATION",
            "identifier": "1023055381",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N.A.T.A. MEMBER #",
            "identifier": "922067",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William James Bonney, M.D.
• Jennifer Lee Bordner
• David Borek, LPC, LCADC
• Shivani Malhotra Borhara, MFT
• Walter Boris, DO
• Alexa Borrows, MS, LAC, NCC
• Boston Brace International Inc. (Boston Orthotics & Prosthetics)
• Michael Steven Boulos
• Patricia Bowe, OT
• Jessica Rochelle Bowen, D.M.D., M.D.S.

• Athletic Trainer in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Athletic Trainer in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.