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Individual
ALAN BALAVENDER
Active
Individual
ALAN BALAVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3638
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004201018
—
CT
01
—
080003638CT09
ANTHEM BLUE CROSS BLUE SH
CT
01
—
080003638CT10
ANTHEM BC BS
CT
01
—
080003638CT12
ANTHEM BC BS
CT
01
—
080003638CT13
ANTHEM BC BS
CT
01
—
080003638CT14
BLUE SHIELD
CT
01
—
080003638CT15
BLUE SHIELD
CT
Enumeration date
10/20/2006
Last updated
10/26/2007
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