MEDICARE: DR. MIHAELA BALAESCU 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
1	207R00000X	Internal Medicine Physician	216737	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1952414815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIHAELA BALAESCU MD

Provider Business Mailing Address
First Line	:	4701 QUEENS BLVD STE 403
Second Line	:
City	:	SUNNYSIDE
State	:	NY
Zip	:	11104-1606
Country	:	US
Telephone Number	:	718-784-7500
Fax Number	:	718-361-1130

Provider Business Practice Location Address
First Line	:	4701 QUEENS BLVD
Second Line	:	SUITE 403
City	:	SUNNYSIDE
State	:	NY
Zip	:	11104-1600
Country	:	US
Telephone Number	:	718-784-7500
Fax Number	:	646-967-4035

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

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	06/14/2023

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