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Individual
MATTHEW BALLON
Active
Individual
MATTHEW BALLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
688403
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
F409159-01
NY
Other
Enumeration date
01/31/2026
Last updated
09/11/2026
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