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General NPI Number Information
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NPI Number | 1255661211
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Entity Type | Individual
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Provider Name | GERARD ANTHONY BALTAZAR D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/13/2010
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 5 PERRYRIDGE RD
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City | GREENWICH
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State | CT
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Zip | 06830-4608
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Country | US
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Telephone | 203-863-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 405 WILMOT RD
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City | NEW ROCHELLE
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State | NY
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Zip | 10804-1019
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Country | US
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Telephone | 646-596-6161
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 255827
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 255827
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 255827
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License Number State | NY
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