Provider Demographics
NPI:1215004536
Name:BALDE, ALSENY (MD, MPH)
Entity Type:Individual
Prefix:
First Name:ALSENY
Middle Name:
Last Name:BALDE
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1643 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-2916
Mailing Address - Country:US
Mailing Address - Phone:718-328-1900
Mailing Address - Fax:718-328-1901
Practice Address - Street 1:1643 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-2916
Practice Address - Country:US
Practice Address - Phone:718-328-1900
Practice Address - Fax:718-328-1901
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2015-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250592207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03046839Medicaid
I71854Medicare UPIN
NY03046839Medicaid