Provider Demographics
NPI:1063489243
Name:BALANI, BINDU A (MD)
Entity Type:Individual
Prefix:
First Name:BINDU
Middle Name:A
Last Name:BALANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BINDU
Other - Middle Name:A
Other - Last Name:VAZIRANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:20 PROSPECT AVE
Mailing Address - Street 2:SUITE 507
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1997
Mailing Address - Country:US
Mailing Address - Phone:201-487-4088
Mailing Address - Fax:201-489-8930
Practice Address - Street 1:20 PROSPECT AVE
Practice Address - Street 2:SUITE 507
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1997
Practice Address - Country:US
Practice Address - Phone:201-487-4088
Practice Address - Fax:201-489-8930
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07116400207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH31955Medicare UPIN
NJ045688DSXMedicare ID - Type Unspecified