Individual
JENNIFER BALLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
450 CLARKSON AVE # 1228, DEPT OF EMERGENCY MEDICINE, BROOKLYN, NY 11203-2012
(718) 245-4795
Mailing address
450 CLARKSON AVE # 1228, DEPT OF EMERGENCY MEDICINE, BROOKLYN, NY 11203-2012
(718) 245-4795
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
125-064394
IL
207P00000X
Emergency Medicine Physician
Primary
265780-1
NY
207P00000X
Emergency Medicine Physician
A111025
CA
207R00000X
Internal Medicine Physician
125-064394
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125-064394
STATE LISCENSE NUMBER
IL
01
—
265780-1
NY MEDICAL LICENSE
NY
01
—
A111025
CA MEDICAL LICENSE
CA
Enumeration date
10/17/2008
Last updated
08/01/2024
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