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General NPI Number Information
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NPI Number | 1861576456
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Entity Type | Individual
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Provider Name | GERRY G. BALOYO PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 02/08/2021
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Provider Practice Location Address
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Address Line | 3500 MAIN ST STE 201
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City | SPRINGFIELD
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State | MA
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Zip | 01107-1150
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Country | US
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Telephone | 413-794-0900
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Fax | 413-794-2996
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Provider Business Mailing Address
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Address Line | 280 CHESTNUT ST 2ND FLOOR
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City | SPRINGFIELD
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State | MA
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Zip | 01199-1000
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Country | US
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Telephone | 413-794-5700
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 1442
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License Number State | MA
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