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Individual

CELESTE STAHL BALABAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
21 N MAIN ST, MIDDLEPORT, NY 14105-1027
(716) 735-7774
Mailing address
21 N MAIN ST, MIDDLEPORT, NY 14105-1027
(716) 735-7774

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34-009698
OH
207R00000X
Internal Medicine Physician
Primary
60.258257
NY

Other

Enumeration date
07/03/2008
Last updated
10/15/2010
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