Provider Demographics
NPI:1164415915
Name:BALSKY, DONALD (DPM)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:BALSKY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 WOODSIDE AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1461
Mailing Address - Country:US
Mailing Address - Phone:914-941-0596
Mailing Address - Fax:914-941-0372
Practice Address - Street 1:127 WOODSIDE AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1461
Practice Address - Country:US
Practice Address - Phone:914-941-0596
Practice Address - Fax:914-941-0372
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002653213E00000X
NY027828-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T50844Medicare UPIN
NYP30081Medicare UPIN