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NPI Code Detail

MEDICARE: BETH A BALKO

MEDICARE:   BETH A BALKO
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
1101Y00000XCounselor8473CT

General Provider Information

NPI Number : 1629950530
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH A BALKO
Provider Business Mailing Address
First Line : 100 ELIZABETH ST
Second Line :
City : DERBY
State : CT
Zip : 06418-1819
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 516 LONG HILL AVE
Second Line :
City : SHELTON
State : CT
Zip : 06484-4260
Country : US
Telephone Number : 203-906-5425
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2025
Last Update Date : 07/22/2025

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Directions to “ BETH A BALKO ” Practice Location

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