Individual
BRANDON BALABUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(516) 712-0706
Mailing address
71 BOYD ST, LONG BEACH, NY 11561-2516
(516) 712-0706
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
017725
NY
Other
Enumeration date
07/12/2014
Last updated
07/12/2014
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