Healthcare Provider Details
I. General information
NPI: 1083872493
Provider Name (Legal Business Name): ZARINE ROHINTON BALSARA MD/PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/02/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 BOWMAN DR STE E360
VOORHEES NJ
08043-9603
US
IV. Provider business mailing address
46 LAKE VILLAGE DR
DURHAM NC
27713-8943
US
V. Phone/Fax
- Phone: 856-751-7880
- Fax: 856-751-9133
- Phone: 617-784-0851
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | MD460542 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2088P0231X |
| Taxonomy | Pediatric Urology Physician |
| License Number | MD460542 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: