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Individual

DR. JERRY RAY BALENTINE JR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4422 3RD AVE, ST.BARNABAS HOSPITAL, BRONX, NY 10457-2545
(718) 960-6371
Mailing address
237 GRACE CHURCH ST, RYE, NY 10580-4217
(718) 960-6371

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
181012
NY

Other

Enumeration date
09/08/2005
Last updated
07/08/2007
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