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Individual

ERIC BALLECER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5 CUBA HILL RD, GREENLAWN, NY 11740-1624
(631) 628-5000
Mailing address
6986 N GLEN SHORE DR, GLENDALE, WI 53209-2841
(414) 759-7000

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
300758
NY
390200000X
Student in an Organized Health Care Education/Training Program
NY

Other

Enumeration date
06/22/2016
Last updated
05/13/2022
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