MEDICARE: MR. NILESH N BALAR M.D.

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	2086S0129X	Vascular Surgery Physician	209680	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568460491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NILESH N BALAR M.D.

Provider Business Mailing Address
First Line	:	3175 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-5700
Country	:	US
Telephone Number	:	718-823-7135
Fax Number	:	718-823-7136

Provider Business Practice Location Address
First Line	:	3175 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-5700
Country	:	US
Telephone Number	:	718-823-7135
Fax Number	:	718-823-7136

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	12/05/2007

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