Provider Demographics
NPI:1326374422
Name:BALAMACI, CRIS S (PA)
Entity Type:Individual
Prefix:MS
First Name:CRIS
Middle Name:S
Last Name:BALAMACI
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:95 GRASSLANDS RD
Mailing Address - Street 2:CEDARWOOD HALL LOWER LEVEL
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1652
Mailing Address - Country:US
Mailing Address - Phone:914-493-7469
Mailing Address - Fax:914-493-7968
Practice Address - Street 1:95 GRASSLANDS RD
Practice Address - Street 2:CEDARWOOD HALL LOWER LEVEL
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1652
Practice Address - Country:US
Practice Address - Phone:914-493-7469
Practice Address - Fax:914-493-7968
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY23-008787363A00000X
CT000434363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical