MEDICARE: DR. IGOR BALATSKY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME105590	FL
2	207R00000X	Internal Medicine Physician	228787	NY
3	208M00000X	Hospitalist Physician	25MA09309900	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437159670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IGOR BALATSKY MD

Provider Business Mailing Address
First Line	:	200 TRENTON ROAD
Second Line	:
City	:	BROWNS MILLS
State	:	NJ
Zip	:	08015
Country	:	US
Telephone Number	:	609-893-6611
Fax Number	:	321-259-0635

Provider Business Practice Location Address
First Line	:	200 TRENTON ROAD
Second Line	:
City	:	BROWNS MILLS
State	:	NJ
Zip	:	08015
Country	:	US
Telephone Number	:	609-893-6611
Fax Number	:	321-434-1775

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	10/17/2022

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