Healthcare Provider Details

I. General information

NPI: 1164415915
Provider Name (Legal Business Name): DONALD BALSKY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 03/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 WOODSIDE AVE SUITE 202
BRIARCLIFF MANOR NY
10510-1461
US

IV. Provider business mailing address

127 WOODSIDE AVE SUITE 202
BRIARCLIFF MANOR NY
10510-1461
US

V. Phone/Fax

Practice location:
  • Phone: 914-941-0596
  • Fax: 914-941-0372
Mailing address:
  • Phone: 914-941-0596
  • Fax: 914-941-0372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number027828-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN002653
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: