Individual
DR. DIANE G FRIES-BALOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
27OA00519300
NJ
152W00000X
Optometrist
Primary
OEG001588
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018193600003
—
PA
01
—
1105628
AETNA HMO
PA
01
—
4390338
AETNA PPO
PA
01
—
55470
DAVISVISION
PA
01
—
766110
HIGHMARK BC/BS
PA
01
—
NJ1588
EYEMED
PA
01
—
PA77433-1
VISION BENEFITS OF AMERICA (VBA)
PA
Enumeration date
07/27/2006
Last updated
11/10/2025
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