Joan Balaban, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD038814E Issued in PA

Practice address

6910 Wissahickon Ave
Philadelphia, PA 19119-3728

Phone

(215) 844-2044

Fax

(215) 844-2046

NPI assigned

Apr 6, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mrs. Joan Cantor Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238976000000",
    "number": "1760624894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 WISSAHICKON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191193728",
            "telephone_number": "215-844-2044",
            "fax_number": "215-844-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 WISSAHICKON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191193728",
            "telephone_number": "215-844-2044",
            "fax_number": "215-844-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALABAN",
        "first_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-06",
        "last_updated": "2009-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD038814E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "MD038814E",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "MD038814E",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOAN",
            "last_name": "CANTOR",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Philadelphia, PA
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.