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NPI Code Detail

MEDICARE: DR. SARAH BALASTER D.M.D.

MEDICARE:  DR. SARAH  BALASTER  D.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
1122300000XDentistDI02569200NJ
21223P0300XPeriodontics22DI02569200NJ
31223P0300XPeriodontics058626-1NY
41223P0300XPeriodontics13705CT

General Provider Information

NPI Number : 1942613518
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SARAH BALASTER D.M.D.
Provider Business Mailing Address
First Line : 112-114 MAIN STREET
Second Line :
City : ESOPUS
State : NY
Zip : 12429
Country : US
Telephone Number : 914-486-4894
Fax Number :
Provider Business Practice Location Address
First Line : 324 ELM ST STE 103A
Second Line :
City : MONROE
State : CT
Zip : 06468-2281
Country : US
Telephone Number : 203-268-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2014
Last Update Date : 04/19/2024

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Directions to “ DR. SARAH BALASTER D.M.D.” Practice Location

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