Provider Demographics
NPI:1487041604
Name:BALUCANI, CLOTILDE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CLOTILDE
Middle Name:
Last Name:BALUCANI
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 CLARKSON AVE
Mailing Address - Street 2:NEUROLOGY DEPARTMENT, SUNY DOWNSTATE MEDICAL CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2012
Mailing Address - Country:US
Mailing Address - Phone:718-270-2051
Mailing Address - Fax:718-270-3840
Practice Address - Street 1:450 CLARKSON AVE
Practice Address - Street 2:NEUROLOGY DEPARTMENT, SUNY DOWNSTATE MEDICAL CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2012
Practice Address - Country:US
Practice Address - Phone:718-270-2051
Practice Address - Fax:718-270-3840
Is Sole Proprietor?:No
Enumeration Date:2015-04-26
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3004242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology