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General NPI Number Information
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NPI Number | 1730147521
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Entity Type | Individual
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Provider Name | VIRINCHI R BALA MBBS
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Gender | Male
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 04/05/2012
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Provider Practice Location Address
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Address Line | 920 LARK DR
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City | ALBANY
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State | NY
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Zip | 12207-1300
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Country | US
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Telephone | 518-465-4771
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Fax | 518-242-4784
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Provider Business Mailing Address
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Address Line | 920 LARK DR
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City | ALBANY
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State | NY
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Zip | 12207-1300
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Country | US
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Telephone | 518-465-4771
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Fax | 518-242-4784
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 192867
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License Number State | NY
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