Provider Demographics
NPI:1154457620
Name:BALLABAN, PAULINA MARIA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:PAULINA
Middle Name:MARIA
Last Name:BALLABAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:424 E 77TH ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2312
Mailing Address - Country:US
Mailing Address - Phone:212-241-3809
Mailing Address - Fax:212-996-9239
Practice Address - Street 1:ONE GUSTAVE LEVY PLACE
Practice Address - Street 2:MOUNT SINAI HOSPITAL BOX 1201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-3809
Practice Address - Fax:212-996-9239
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF381677-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics