Provider Demographics
NPI:1114459997
Name:BALI, RADHIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:RADHIKA
Middle Name:
Last Name:BALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WESTCHESTER AVE STE N715
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-1369
Mailing Address - Country:US
Mailing Address - Phone:914-607-5730
Mailing Address - Fax:914-457-1195
Practice Address - Street 1:73 MARKET ST
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-7616
Practice Address - Country:US
Practice Address - Phone:914-848-8085
Practice Address - Fax:914-848-8061
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316271207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine