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Individual

MOHAMAD BALTI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3112 SHERIDAN DR, AMHERST, NY 14226-1904
(716) 831-9435
Mailing address
PO BOX 2461, BUFFALO, NY 14240-2461
(716) 834-1191

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
139264
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
139264
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00011260201
UNIVERA
01
00020545801
UNIVERA
NY
01
000565033001
BLUE CROSS
NY
05
00581315
NY
01
051820982
RAILROAD MEDICARE
01
2005260
INDEPENDENT HEALTH
NY
Enumeration date
03/24/2006
Last updated
03/11/2009
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