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General NPI Number Information
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NPI Number | 1821891458
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Entity Type | Organization
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Legal Business Name | EDWARD BALZER, NURSE PRACTITIONER IN PSYCHIATRY, P.C.
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Dates
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Enumeration Date | 03/29/2025
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Last Update Date | 03/29/2025
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Provider Practice Location Address
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Address Line | 51 RIVIERA DR
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City | MASTIC BEACH
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State | NY
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Zip | 11951-6024
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Country | US
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Telephone | 631-681-5584
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 601
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City | MASTIC BEACH
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State | NY
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Zip | 11951-0601
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Country | US
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Telephone | 631-681-5584
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. EDWARD F BALZER
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Credential | PMHNP-BC
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Telephone | 631-681-5584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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