Healthcare Provider Details

I. General information

NPI: 1255917670
Provider Name (Legal Business Name): DANILO BALATBAT VENTURA JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2119 ROUTE 88 E
BRICK NJ
08724-3227
US

IV. Provider business mailing address

2119 ROUTE 88 E
BRICK NJ
08724-3227
US

V. Phone/Fax

Practice location:
  • Phone: 732-899-0008
  • Fax: 732-899-0447
Mailing address:
  • Phone: 732-899-0008
  • Fax: 732-899-0447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA12317300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: