Balaji Gopidasan, M.B.B.S.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

L2956 Issued in AL

Practice address

620 Madison St
Syracuse, NY 13210-2319

Phone

(315) 426-3630

NPI assigned

Jun 19, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1336300607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 MAPLE RD",
            "address_2": "APPT # 1B",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 MADISON ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102319",
            "telephone_number": "315-426-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOPIDASAN",
        "first_name": "BALAJI",
        "credential": "M.B.B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "AL",
            "license": "L2956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ann Goodyear, FNP
• Morgan Goold Santimaw, LMFT
• Maithili Gopalakrishnan, MD
• Veena Gopalakrishnan
• Sanjay Rao Gergal Gopalkrishna Rao
• Chaitra Gopinath
• Viral Goradia, M.B.B.S
• Rachel Ann Gorcyca
• Melissa Gorczynski, MD
• Judie Lyn Gordon-Louison

• Child & Adolescent Psychiatry Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Child & Adolescent Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.