Agnes Balogh, MD

Individual provider Active NPI Anesthesiology Physician · Fairview, NJ

NPI 1275244154 · NPPES record last updated Dec 12, 2022

Key facts

NPI
1275244154
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiology Physician 207L00000X
License
25MA11655400 (NJ)
Practice address
143 Anderson Ave
Fairview, NJ 07022-2001
Phone
(201) 482-1134
NPI assigned
Dec 12, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA11655400NJMDAnesthesiology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA11655400 NJ Yes

Addresses

Primary practice location

143 Anderson Ave
Fairview, NJ 07022-2001

Mailing address

29 Lloyd Rd
Montclair, NJ 07042-1705
Phone (862) 229-3827

Other providers in Fairview, NJ

All providers in Fairview, NJ · Anesthesiology Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.