Provider Demographics
NPI:1164731303
Name:BALABANOVA-TSARNAKOVA, RALITSA V (MD)
Entity Type:Individual
Prefix:
First Name:RALITSA
Middle Name:V
Last Name:BALABANOVA-TSARNAKOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RALITSA
Other - Middle Name:V
Other - Last Name:TSARNAKOVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1850 E PARK AVE
Mailing Address - Street 2:STE 302
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-6706
Mailing Address - Country:US
Mailing Address - Phone:814-278-4680
Mailing Address - Fax:814-235-1523
Practice Address - Street 1:1850 E PARK AVE
Practice Address - Street 2:STE 302
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-6706
Practice Address - Country:US
Practice Address - Phone:814-278-4680
Practice Address - Fax:814-235-1523
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD441329207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine