Provider Demographics
NPI:1447582135
Name:BALERDI, M AURORA (MD)
Entity Type:Individual
Prefix:
First Name:M AURORA
Middle Name:
Last Name:BALERDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:M AURORA
Other - Middle Name:
Other - Last Name:BALERDI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:407 EAST AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5299
Mailing Address - Country:US
Mailing Address - Phone:401-725-4700
Mailing Address - Fax:401-725-4740
Practice Address - Street 1:407 EAST AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5299
Practice Address - Country:US
Practice Address - Phone:401-725-4700
Practice Address - Fax:401-725-4740
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD09305207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G33042Medicare UPIN