Individual
MR. MICHAEL STEPHEN BALLETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 AMSTERDAM AVE, NEW YORK, NY 10025-1716
(212) 523-5918
Mailing address
1111 AMSTERDAM AVE, NEW YORK, NY 10025-1716
(212) 523-5918
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F305718-1
NY
Other
Enumeration date
12/06/2011
Last updated
05/02/2013
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