# MR. MICHAEL STEPHEN BALLETTA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1023386935
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | F305718-1 | NY | Yes |

## Other

- **Enumeration date:** 12/06/2011
- **Last updated:** 05/02/2013