Individual
ELIJAH BALAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 DAVIS SQ, SOMERVILLE, MA 02144-2904
(786) 555-8998
Mailing address
255 ELM ST STE 204, SOMERVILLE, MA 02144-2947
(617) 623-6111
(617) 616-5084
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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