Individual provider · NPI-1

Dr. Dvorah Balsam, MD

Radiology, Pediatric Radiology · Stony Brook, NY

NPI number1871539155
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1871539155
Entity type
Individual (NPI-1)
Name
Dr. Dvorah Balsam
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Jun 22, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2085P0229X Radiology, Pediatric Radiology101354NYYes

Practice location

University Hospital At Stony Brook
Level 4
Stony Brook, NY 11794-0001

Phone 631-444-6919

Mailing address

Po Box 1559
Stony Brook, NY 11790-0989

Phone 631-444-6919

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