Jean Baluta
Individual provider Active NPI Specialist · Liverpool, NY
NPI 1790367134 · NPPES record last updated Apr 26, 2021
Key facts
- NPI
- 1790367134
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 8202 Penelope Lane
Liverpool, NY 13090-6881 - Phone
- (315) 345-2460
- NPI assigned
- Apr 26, 2021
- 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)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | NY | Yes |
Addresses
Primary practice location
8202 Penelope Lane
Liverpool, NY 13090-6881
Mailing address
8202 Penelope Lane
Liverpool, NY 13090-6881
Phone (315) 345-2460
Other providers in Liverpool, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.