MEDICARE: DR. JULIE ELIZABETH BALZANO PH.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	103TC1900X	Counseling Psychologist	020237	NY
2	103TC1900X	Counseling Psychologist	35SI00724500	NJ

General Provider Information

NPI Number	:	1568751881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE ELIZABETH BALZANO PH.D.

Provider Business Mailing Address
First Line	:	41 WATCHUNG PLZ # 390
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07042-4117
Country	:	US
Telephone Number	:	973-818-0162
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 WATCHUNG PLZ # 390
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07042-4117
Country	:	US
Telephone Number	:	973-818-0162
Fax Number	:

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

Provider Enumeration Date	:	04/07/2011
Last Update Date	:	04/09/2025

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