Provider Demographics
NPI:1164425625
Name:BALUYOT, HELEN M (MD)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:M
Last Name:BALUYOT
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 1:641 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-3028
Mailing Address - Country:US
Mailing Address - Phone:973-754-2575
Mailing Address - Fax:973-754-2579
Practice Address - Street 1:641 MAIN ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-3028
Practice Address - Country:US
Practice Address - Phone:973-754-2575
Practice Address - Fax:973-754-2579
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA64305208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7826702Medicaid
NJ7826702Medicaid