Provider Demographics
NPI:1801160445
Name:BORGNA, KAELY ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:KAELY
Middle Name:ELIZABETH
Last Name:BORGNA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KAELY
Other - Middle Name:ELIZABETH
Other - Last Name:AIKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:1800 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-2369
Practice Address - Country:US
Practice Address - Phone:570-963-1740
Practice Address - Fax:570-963-5780
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055257363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical