Individual
MISS ELIZABETH BALANTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
12 COLUMBUS PL, STAMFORD, CT 06907-1610
(203) 360-0778
Mailing address
12 COLUMBUS PL, STAMFORD, CT 06907-1610
(203) 360-0778
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
300524-1
NY
Other
Enumeration date
09/15/2010
Last updated
10/22/2010
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