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NPI Code Detail

MEDICARE: DR. BALSHIK MIN M.D.

MEDICARE: DR. BALSHIK MIN 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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician135937NY

Other Identifiers

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

General Provider Information

NPI Number : 1629067434
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BALSHIK MIN M.D.
Provider Business Mailing Address
First Line : 19 ROLLINGWOOD DR
Second Line :
City : NEW HARTFORD
State : NY
Zip : 13413-2707
Country : US
Telephone Number : 315-793-3238
Fax Number : 315-338-7340
Provider Business Practice Location Address
First Line : 1500 N JAMES ST
Second Line :
City : ROME
State : NY
Zip : 13440-2844
Country : US
Telephone Number : 315-338-7045
Fax Number : 315-338-7340
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2005
Last Update Date : 07/08/2007

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