Provider Demographics
NPI:1053572198
Name:BORJA, JOGLE ANN BACNIS (RN)
Entity type:Individual
Prefix:MS
First Name:JOGLE ANN
Middle Name:BACNIS
Last Name:BORJA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JOGLE
Other - Middle Name:A
Other - Last Name:BORJA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:65 SANTA ROSA LN
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-7594
Mailing Address - Country:US
Mailing Address - Phone:732-493-5616
Mailing Address - Fax:
Practice Address - Street 1:727 N BEERS ST
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1514
Practice Address - Country:US
Practice Address - Phone:732-739-5900
Practice Address - Fax:732-888-7318
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26N011890800282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural