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NPI Code Detail

MEDICARE: DR. EDWARD BALACI MD

MEDICARE: DR. EDWARD BALACI MD
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
12085B0100XBody Imaging Physician210748NY
22085R0202XDiagnostic Radiology Physician210748NY

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 : 1932177870
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD BALACI MD
Provider Business Mailing Address
First Line : PO BOX 23
Second Line :
City : CANAJOHARIE
State : NY
Zip : 13317-0023
Country : US
Telephone Number : 607-729-2125
Fax Number :
Provider Business Practice Location Address
First Line : 32-36 HARRISON ST
Second Line :
City : JOHNSON CITY
State : NY
Zip : 13790-2122
Country : US
Telephone Number : 607-729-1999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 04/27/2019

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Directions to “ DR. EDWARD BALACI MD” Practice Location

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