Provider Demographics
NPI:1366640567
Name:CAROL A BALFE, OD, PC
Entity Type:Organization
Organization Name:CAROL A BALFE, OD, PC
Other - Org Name:MOHAWK VALLEY EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BALFE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:518-673-2015
Mailing Address - Street 1:70 ERIE BLVD
Mailing Address - Street 2:
Mailing Address - City:CANAJOHARIE
Mailing Address - State:NY
Mailing Address - Zip Code:13317-1133
Mailing Address - Country:US
Mailing Address - Phone:518-673-2015
Mailing Address - Fax:
Practice Address - Street 1:70 ERIE BLVD
Practice Address - Street 2:
Practice Address - City:CANAJOHARIE
Practice Address - State:NY
Practice Address - Zip Code:13317-1133
Practice Address - Country:US
Practice Address - Phone:518-673-2015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005534152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA1101Medicare PIN
NY5981950001Medicare NSC
NYRB3628Medicare PIN