Individual
BRENDA K. BALCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
53 C GRANITE STREET, NEW LONDON, CT 06320
(860) 442-8817
(860) 442-2011
Mailing address
53 C GRANITE STREET, NEW LONDON, CT 06320
(860) 442-8817
(860) 442-2011
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
031470
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001314707-00
BLUE CARE FAMILY PLAN
—
01
—
010031470CT01
BLUE CROSS
—
01
—
NLP071
OXFORD
—
01
—
OV6152
HEALTH NET
—
Enumeration date
09/22/2006
Last updated
07/08/2007
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