MEDICARE: ANEESHA KHAN BALOCH MHC-LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	P137098	NY

General Provider Information

NPI Number	:	1154205441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANEESHA KHAN BALOCH MHC-LP

Provider Business Mailing Address
First Line	:	2 PINE WEST PLZ STE 204
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12205-5532
Country	:	US
Telephone Number	:	518-713-4008
Fax Number	:	518-444-7095

Provider Business Practice Location Address
First Line	:	2 PINE WEST PLZ STE 204
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12205-5532
Country	:	US
Telephone Number	:	518-713-4008
Fax Number	:	518-444-7095

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2025
Last Update Date	:	08/01/2025

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