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NPI Code Detail

MEDICARE: DR. FRANCIS XAVIER BALSAMO DDS

MEDICARE: DR. FRANCIS XAVIER BALSAMO DDS
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
11223G0001XGeneral Practice Dentistry22DI01169300NJ

General Provider Information

NPI Number : 1316955503
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FRANCIS XAVIER BALSAMO DDS
Provider Business Mailing Address
First Line : 134 WASHINGTON AVE
Second Line :
City : LITTLE FERRY
State : NJ
Zip : 07643-2042
Country : US
Telephone Number : 201-641-9119
Fax Number : 201-641-2664
Provider Business Practice Location Address
First Line : 134 WASHINGTON AVE
Second Line :
City : LITTLE FERRY
State : NJ
Zip : 07643-2042
Country : US
Telephone Number : 201-641-9119
Fax Number : 201-641-2664
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2006
Last Update Date : 07/08/2007

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