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General NPI Number Information
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NPI Number | 1760625479
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Entity Type | Organization
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Legal Business Name | JOSEPH R. BALZARETT, M.D., P.C.
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Dates
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Enumeration Date | 04/10/2009
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Last Update Date | 04/10/2009
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Provider Practice Location Address
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Address Line | 8206 LEESBURG PIKE STE 207
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City | VIENNA
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State | VA
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Zip | 22182-2614
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Country | US
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Telephone | 703-893-8585
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Fax | 703-893-3879
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Provider Business Mailing Address
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Address Line | 8206 LEESBURG PIKE STE 207
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City | VIENNA
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State | VA
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Zip | 22182-2614
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Country | US
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Telephone | 703-893-8585
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Fax | 703-893-3879
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. JOSEPH R. BALZARETT
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Credential | M.D.
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Telephone | 703-893-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 0101023170
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 0101023170
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License Number State | VA
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