Individual
DR. THOMAS JOHN BALCEZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06504-8900
(203) 688-1343
(203) 688-7152
Mailing address
500 E MAIN ST, STE 212, BRANFORD, CT 06400
(203) 481-5665
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
033928
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001339285
—
CT
Enumeration date
08/02/2006
Last updated
05/06/2008
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