Basic Information
| Provider Information | |||||||||
| NPI: | 1053532465 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURT-LIBO | ||||||||
| FirstName: | BORISLAVA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 227 LAUREL RD | ||||||||
| Address2: | STE 300 | ||||||||
| City: | VOORHEES | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080438303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566696050 | ||||||||
| FaxNumber: | 8566510794 | ||||||||
| Practice Location | |||||||||
| Address1: | 312 PROFESSIONAL VIEW DR | ||||||||
| Address2: | BLDG 300 | ||||||||
| City: | FREEHOLD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077287904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7324311616 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 04/17/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 2434811 | NY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.