Healthcare Provider Details

I. General information

NPI: 1194611301
Provider Name (Legal Business Name): EMMA BALKIN APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 ROUTE 70 E STE 7&5
CHERRY HILL NJ
08003-2123
US

IV. Provider business mailing address

11006 GAITHER FARM RD
ELLICOTT CITY MD
21042-6125
US

V. Phone/Fax

Practice location:
  • Phone: 443-889-5963
  • Fax:
Mailing address:
  • Phone: 443-889-5963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP034459
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: