Organization
BALOURIS EYE CENER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONSTANTINE A BALOURIS M.D. (PRESIDENT)
(724) 482-0090
Entity
Organization
Contact information
Practice address
102 TECHNOLOGY DR, SUITE 120, BUTLER, PA 16001-1782
(724) 482-0090
(724) 482-0093
Mailing address
102 TECHNOLOGY DR, SUITE 120, BUTLER, PA 16001-1782
(724) 482-0090
(724) 482-0093
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001691450
—
PA
01
—
1501183
GATEWAY
PA
01
—
1755548
HIGHMARK
PA
01
—
DD7831
RAILROAD MEDICARE
PA
Enumeration date
01/31/2007
Last updated
08/14/2009
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