Healthcare Provider Details

I. General information

NPI: 1487650222
Provider Name (Legal Business Name): JOSEPH BALSAMO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1591 BOSTON POST RD STE 100
GUILFORD CT
06437-4335
US

IV. Provider business mailing address

1 CELLINI PL STE 102
WEST HAVEN CT
06516-1666
US

V. Phone/Fax

Practice location:
  • Phone: 203-932-6481
  • Fax: 203-932-4051
Mailing address:
  • Phone: 203-932-6481
  • Fax: 203-889-4953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number031839
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: