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General NPI Number Information
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NPI Number | 1588210405
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Entity Type | Individual
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Provider Name | MRS. KAREN VALERIE BALSAMO
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Gender | Female
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Dates
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Enumeration Date | 08/15/2019
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Last Update Date | 08/15/2019
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Provider Practice Location Address
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Address Line | 700 AIRPORT RD
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5907
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Country | US
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Telephone | 732-367-4700
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Fax | 732-364-4190
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Provider Business Mailing Address
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Address Line | 173 CHERRY QUAY RD
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City | BRICK
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State | NJ
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Zip | 08723-6303
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Country | US
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Telephone | 908-814-6942
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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 | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 26NO06598000
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License Number State | NJ
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