Individual
CHERYL BALSAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
617 PRESCOTT PL, VALLEY STREAM, NY 11581-3033
(718) 801-1904
Mailing address
617 PRESCOTT PL, VALLEY STREAM, NY 11581-3033
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
026661-1
NY
Other
Enumeration date
12/08/2008
Last updated
12/08/2008
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