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Individual
EDWARD BALLO
Active
Individual
EDWARD BALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
72097986
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02997148
—
NY
Enumeration date
01/05/2017
Last updated
01/05/2017
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