Provider Demographics
NPI:1164698601
Name:BALAS, MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:BALAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:462 GRIDER ST
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY, ERIE COUNTY MEDICAL CENTER
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-3021
Mailing Address - Country:US
Mailing Address - Phone:716-898-4221
Mailing Address - Fax:716-898-3658
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY, ERIE COUNTY MEDICAL CENTER
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3021
Practice Address - Country:US
Practice Address - Phone:716-898-4221
Practice Address - Fax:716-898-3658
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2475072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry