Individual
MRS. CONSTADINA BALIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., P.T.
Contact information
Practice address
1615 BELL BLVD, BAYSIDE, NY 11360-1639
(718) 279-7979
Mailing address
1615 BELL BLVD, BAYSIDE, NY 11360-1639
(718) 279-7979
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
018769-1
NY
2251P0200X
Pediatric Physical Therapist
018769-1
NY
Other
Enumeration date
11/19/2008
Last updated
11/19/2008
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