Individual
AVINASH LUTCHMIDATH BALLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1676 SUNSET AVE, UTICA, NY 13502
(315) 724-3456
(315) 724-6734
Mailing address
136 EVERGREEN LN, WHITESBORO, NY 13492-2553
(646) 334-4436
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
260616
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/26/2010
Last updated
05/23/2018
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