Provider Demographics
NPI:1104186196
Name:BIALO, DARREN (MD)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:
Last Name:BIALO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 ROUTE 38
Mailing Address - Street 2:
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036-2702
Mailing Address - Country:US
Mailing Address - Phone:609-261-4500
Mailing Address - Fax:215-349-2664
Practice Address - Street 1:1295 ROUTE 38
Practice Address - Street 2:
Practice Address - City:HAINESPORT
Practice Address - State:NJ
Practice Address - Zip Code:08036-2702
Practice Address - Country:US
Practice Address - Phone:609-261-4500
Practice Address - Fax:215-349-2664
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT2101912085R0202X
RIMD143972085R0202X
PAMD4578152085R0202X
NJ25MA100349002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology