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General NPI Number Information
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NPI Number | 1487699633
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Entity Type | Individual
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Provider Name | RAVI BALIGA MD
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Gender | Male
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 01/13/2011
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Provider Practice Location Address
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Address Line | 59 KOCH AVE GREYSTONE PARK PSYCHIATRIC HOSPITAL
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City | MORRIS PLAINS
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State | NJ
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Zip | 07950-4400
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Country | US
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Telephone | 973-538-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 18 SPARROW RD
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City | RANDOLPH
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State | NJ
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Zip | 07869-2129
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Country | US
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Telephone | 973-300-4110
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Fax | 973-579-9007
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA03046500
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License Number State | NJ
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