Healthcare Provider Details

I. General information

NPI: 1780558403
Provider Name (Legal Business Name): BALATI EMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2025
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 WESTCHESTER AVE
WHITE PLAINS NY
10604-3520
US

IV. Provider business mailing address

181 CROSS ST FL 1
BRONX NY
10464-1225
US

V. Phone/Fax

Practice location:
  • Phone: 929-460-8543
  • Fax:
Mailing address:
  • Phone: 929-460-8543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. HILLARY FAJARDO
Title or Position: CEO
Credential: EMT
Phone: 347-697-5088