Balaishe Boakai Ballo
Nurse Anesthetist, Certified Registered in Camden, NJ. Individual provider (NPI-1).
Details
- NPI
- 1003672346
- Entity type
- Individual (NPI-1)
- Name
- Balaishe Boakai Ballo
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 26, 2024
- Certification date
- Jan 14, 2025
- Last updated
- Jan 14, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
- Can order and refer
- Part B Yes · DME No · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 26NJ15034400 | NJ | Yes |
| 367500000X | Nurse Anesthetist, Certified Registered | 147728 | PA |
Practice location
1600 Haddon Ave Fl 3Camden, NJ 08103-3101
Phone 856-988-6260 · Fax 856-988-6270
Mailing address
301 Lippincott Dr Ste 410Marlton, NJ 08053-4197
Phone 856-988-6260 · Fax 856-988-6270
Other practice locations
Camden, NJ 08103-3101
Phone 856-757-3500
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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