Individual provider · NPI-1

Vita Merylle Balista

Nurse Practitioner, Family · Valhalla, NY

NPI number1952079485
StatusActive
Last updated in NPPESMay 19, 2023

Details

NPI
1952079485
Entity type
Individual (NPI-1)
Name
Vita Merylle Balista
Sex
Female
Sole proprietor
No
Enumeration date
Aug 31, 2021
Certification date
May 19, 2023
Last updated
May 19, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyF347217-01NYYes

Practice location

100 Woods Rd
Valhalla, NY 10595-1530

Phone 914-493-7518 · Fax 914-493-8130

Mailing address

100 Woods Rd
Valhalla, NY 10595-1530

Phone 914-493-7518

Other practice locations

325 Ny-100
Somers, NY 10589

Phone 914-669-8289

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