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Individual

PRAVEEN BALLABH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 WOODS RD, WESTCHESTER MEDICAL CENTER, VALHALLA, NY 10595-1530
(914) 493-8558
(914) 493-1488
Mailing address
100 WOODS RD, WESTCHESTER MEDICAL CENTER, VALHALLA, NY 10595-1530
(914) 493-8558
(914) 493-1488

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
240324
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003128453
CT
05
02217283
NY
01
A400041188
MEDICARE PTAN
NY
Enumeration date
08/10/2005
Last updated
01/22/2015
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