Provider Demographics
NPI:1477634327
Name:BALAGOT, ROMEO D (MD)
Entity Type:Individual
Prefix:
First Name:ROMEO
Middle Name:D
Last Name:BALAGOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4277 HEMPSTEAD TURNPIKE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-5706
Mailing Address - Country:US
Mailing Address - Phone:516-731-0124
Mailing Address - Fax:516-731-6160
Practice Address - Street 1:4277 HEMPSTEAD TURNPIKE
Practice Address - Street 2:SUITE 107
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5706
Practice Address - Country:US
Practice Address - Phone:516-731-0124
Practice Address - Fax:516-731-6160
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY154724207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A64112Medicare UPIN