Healthcare Provider Details

I. General information

NPI: 1023599727
Provider Name (Legal Business Name): NORA E. BALON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 ELMWOOD AVE
BUFFALO NY
14217-1304
US

IV. Provider business mailing address

53 TRUDY LN
BUFFALO NY
14227-1903
US

V. Phone/Fax

Practice location:
  • Phone: 716-447-6100
  • Fax:
Mailing address:
  • Phone: 716-440-4978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number343539
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: